Evidence map›Paper›PMID 40956567›Full record

ArticleInternational urology and nephrology2026

Clinical outcomes of urologic reconstruction during cytoreductive surgery with HIPEC: a 13-year single-center experience.

Dyvon T Walker, Hunter A Flores, Rohan G Bhalla, Margaret M Higgins, Salvador Rodriguez Franco, Rebeca Gonzalez Jauregui, Brian J Flynn, Steven A Ahrendt, Ty T Higuchi

Abstract readClinical Study
PubMed Publisher
In one paragraph

Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Dyvon T WalkerDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA. dyvon.walker@cuanschutz.edu.
Hunter A FloresDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA.
Rohan G BhallaDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA.
Margaret M HigginsDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA.
Salvador Rodriguez FrancoDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA.
Rebeca Gonzalez JaureguiDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA.
Brian J FlynnDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA.
Steven A AhrendtDepartment of Surgery, Division of Surgical Oncology, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
Ty T HiguchiDepartment of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, 12631 E. 17th Ave., Mail Stop C-319, Aurora, CO, 80045, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is a cornerstone treatment for resectable peritoneal carcinomatosis. Urologic reconstructive surgery is required in 7-20% of cytoreductive surgeries due to urinary tract involvement or injury, yet current literature on outcomes remains limited. This study presents one of the largest single-institution cohorts examining outcomes of urologic reconstruction in CRS/HIPEC cases, and is the first to investigate the impact of preoperative planning and intraoperative timing of urologic reconstruction on postoperative outcomes.

methodsA retrospective analysis of 314 cases was performed from June 2010 to August 2023. Data from cases involving urologic reconstruction were analyzed, including demographics, surgical details, and outcomes. Statistical analyses evaluated associations between surgical variables and short and long-term urologic complications.

resultsUrologic reconstruction was performed in 35 cases (11.1%), with the majority occurring after HIPEC administration. Postoperative urologic complications occurred in 57% of cases. 40% of the urologic reconstruction cases resulted in low-grade, short-term urologic complications (AKI, UTI) while 20% were deemed high-grade (sepsis, urine leak). 29% developed long-term sequelae such as ureteral stricture or urinary retention. Longer operative times were significantly associated with long-term complications. No significant differences were found in long-term complication rates based on the timing of urologic repair (pre-HIPEC or post-HIPEC) or whether urologic intervention was planned prior to surgery. Interestingly, there was a significant association between fewer prior abdominal surgeries and higher complication rates.

conclusionsSurgical complexity and prior surgical history are key determinants of postoperative outcomes following urologic reconstruction at the time of cytoreductive surgery. Timing of urologic intervention and specific preoperative variables, such as age and peritoneal cancer index score, did not significantly impact long-term outcomes. Higher complication rates were also seen among patients with fewer prior abdominal surgeries, which may in part be due to selection bias or other unaccounted variables present in the patients with fewer abdominal surgeries. These findings highlight the importance of individualized surgical planning and inform preoperative discussions about the risks and benefits of CRS with HIPEC.

Indexed as

Cytoreduction Surgical ProceduresHyperthermic Intraperitoneal ChemotherapyPeritoneal NeoplasmsPlastic Surgery ProceduresUrologic Surgical ProceduresAntineoplastic ProtocolsCombined Modality TherapyFemaleHumansMaleMiddle AgedPeritoneumPostoperative ComplicationsProspective StudiesRetrospective StudiesTime FactorsCytoreductive surgeryHIPECPeritoneal neoplasmsUrologic reconstruction

Identifiers

PMID40956567

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.