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Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement.

Publication ,  Journal Article
Brajcich, BC; Bentrem, DJ; Yang, AD; Cohen, ME; Ellis, RJ; Mahalingam, D; Mulcahy, MF; Lidsky, ME; Allen, PJ; Merkow, RP
Published in: Ann Surg Oncol
December 2020

BACKGROUND: Hepatic artery infusion pump (HAIP) chemotherapy is an advanced cancer therapy for primary and secondary hepatic malignancies. The risk of concurrent hepatic and/or colorectal operations with HAIP placement is unknown. Our objective was to characterize the short-term outcomes of concurrent surgery with HAIP placement. METHODS: The 2005-2017 ACS NSQIP dataset was queried for patients undergoing hepatic and colorectal operations with or without HAIP placement. Outcomes were compared for HAIP placement with different combined procedures. Patients who underwent procedures without HAIP placement were propensity score matched with those with HAIP placement. The primary outcome was 30-day death or serious morbidity (DSM). Secondary outcomes included infectious complications, wound complications, length of stay (LOS), and operative time. RESULTS: Of 467 patients who underwent HAIP placement, 83.9% had concurrent surgery. The rate of DSM was 10.7% for HAIP placement alone, 19.2% with concurrent minor hepatic procedures, 22.1% with concurrent colorectal resection, 23.2% with concurrent minor hepatic plus colorectal procedures, 28.4% with concurrent major hepatic resection, and 41.7% with concurrent major hepatic plus colorectal resection. On matched analyses, there was no difference in DSM, infectious, or wound complications for procedures with HAIP placement compared with the additional procedure alone, but operative time (294.7 vs 239.8 min, difference 54.9, 95% CI 42.8-67.0) and LOS (6 vs 5, IRR 1.20, 95% CI 1.08-1.33) were increased. CONCLUSIONS: HAIP placement is not associated with additional morbidity when performed with hepatic and/or colorectal surgery. Decisions regarding HAIP placement should consider the risks of concurrent operations, and patient- and disease-specific factors.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

December 2020

Volume

27

Issue

13

Start / End Page

5098 / 5106

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Male
  • Liver Neoplasms
  • Infusions, Intra-Arterial
  • Humans
  • Hepatic Artery
  • Hepatectomy
  • Female
  • Colorectal Neoplasms
 

Citation

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Brajcich, B. C., Bentrem, D. J., Yang, A. D., Cohen, M. E., Ellis, R. J., Mahalingam, D., … Merkow, R. P. (2020). Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement. Ann Surg Oncol, 27(13), 5098–5106. https://doi.org/10.1245/s10434-020-08938-0
Brajcich, Brian C., David J. Bentrem, Anthony D. Yang, Mark E. Cohen, Ryan J. Ellis, Devalingam Mahalingam, Mary F. Mulcahy, Michael E. Lidsky, Peter J. Allen, and Ryan P. Merkow. “Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement.Ann Surg Oncol 27, no. 13 (December 2020): 5098–5106. https://doi.org/10.1245/s10434-020-08938-0.
Brajcich BC, Bentrem DJ, Yang AD, Cohen ME, Ellis RJ, Mahalingam D, et al. Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement. Ann Surg Oncol. 2020 Dec;27(13):5098–106.
Brajcich, Brian C., et al. “Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement.Ann Surg Oncol, vol. 27, no. 13, Dec. 2020, pp. 5098–106. Pubmed, doi:10.1245/s10434-020-08938-0.
Brajcich BC, Bentrem DJ, Yang AD, Cohen ME, Ellis RJ, Mahalingam D, Mulcahy MF, Lidsky ME, Allen PJ, Merkow RP. Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement. Ann Surg Oncol. 2020 Dec;27(13):5098–5106.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

December 2020

Volume

27

Issue

13

Start / End Page

5098 / 5106

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Male
  • Liver Neoplasms
  • Infusions, Intra-Arterial
  • Humans
  • Hepatic Artery
  • Hepatectomy
  • Female
  • Colorectal Neoplasms