Negative-Pressure Wound Therapy for Open Abdomen in Surgical Reintervention after Curative Surgery of Peritoneal Malignancy Increases the Risk of Recurrence

Thomas Rabel; Pierre-Emmanuel Bonnot; Omar Hadeedi; Vahan Kepenekian; Lorraine Bernard; Arnaud Friggeri; Olivier Glehen; Guillaume Passot

doi:10.1097/ASW.0000000000000018

Negative-Pressure Wound Therapy for Open Abdomen in Surgical Reintervention after Curative Surgery of Peritoneal Malignancy Increases the Risk of Recurrence

Adv Skin Wound Care. 2023 Nov 1;36(11):1-5. doi: 10.1097/ASW.0000000000000018.

Authors

Thomas Rabel¹, Pierre-Emmanuel Bonnot, Omar Hadeedi, Vahan Kepenekian, Lorraine Bernard, Arnaud Friggeri, Olivier Glehen, Guillaume Passot

Affiliation

¹ In the Department of Visceral and Oncologic Surgery, Hospital Lyon Sud, Hospices Civils de Lyon, France, Thomas Rabel, MD, is Resident; Pierre-Emmanuel Bonnot, MD, is Surgical Fellow; Omar Hadeedi, MSc, is Visiting Surgical Fellow; and Vahan Kepenekian, MD, is Surgeon and Faculty. Lorraine Bernard is Biostastistician, Department of Biostatistics, Hospices Civils de Lyon. Arnaud Friggeri, MD, PhD, is Anesthesiologist and Faculty, Department of Anesthesiology and Intensive Care, Hopital Lyon Sud. Also in the Department of Visceral and Oncologic Surgery, Hospital Lyon Sud, Olivier Glehen, MD, PhD, is Surgeon and Head of the Department and Guillaume Passot, MD, PhD, is Surgeon. The authors have disclosed no financial relationships related to this article. Submitted August 17, 2022; accepted in revised form December 9, 2022.

PMID: 37861668
DOI: 10.1097/ASW.0000000000000018

Abstract

Objective: Negative-pressure wound therapy for open abdomen (NPWTOA) helps reduce the risk of abdominal compartment syndrome. However, the risk of recurrence of cancer is unclear when NPWTOA is applied after oncologic resection. The aim of this study was to evaluate the effects of NPWTOA used for major complications on patients treated with cytoreductive surgery for peritoneal malignancy (PM).

Methods: All patients who underwent an NPWTOA after potentially curative surgery of PM in a single institution were included. These patients were pair matched 1:3 on the Peritoneal Cancer Index, completeness of cytoreduction using a scoring index, and PM origin with patients who underwent surgical reintervention without NPWTOA after curative surgery of PM. Survival among the two groups was compared using the Kaplan-Meier method.

Results: Between 2011 and 2017, among 719 curative surgeries for PM, 13 patients underwent an NPWTOA after surgical reintervention. Researchers paired 9 of these patients to 27 others without NPWTOA after surgical reintervention. Median overall survival was 4.8 and 35 months (P = .391), and median disease-free survival was 4.0 and 13.9 months (P = .022) for the NPWTOA and non-NPWTOA groups, respectively.

Conclusions: The use of the NPWTOA during surgical reintervention after curative surgery for PM may increase the risk of early recurrence.

MeSH terms

Abdomen / surgery
Combined Modality Therapy
Cytoreduction Surgical Procedures / adverse effects
Cytoreduction Surgical Procedures / methods
Humans
Hyperthermia, Induced*
Negative-Pressure Wound Therapy*
Peritoneal Neoplasms* / pathology
Peritoneal Neoplasms* / surgery
Retrospective Studies