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Table 1 Surgical procedures in patients undergoing abdominal surgery and pathological findings

From: The prognostic impact of abdominal surgery in cancer patients with neutropenic enterocolitis: a systematic review and meta-analysis, on behalf the Groupe de Recherche en Réanimation Respiratoire du patient d’Onco-Hématologie (GRRR-OH)

Study and year of publication n/n Surgical procedures Pathological findings Surgery indication Mortality after surgery
Mulholland 1983 3/4 Right hemicolectomy with ileostomy (n = 1)
Subtotal colectomy with ileostomy (n = 1)
No resection (n = 1)
Extensive mucosal and submucosal necrosis. No perforation. The submucosa was edematous Cecal perforation (2)
Colic perforation (1)
2/3
Mower 1986 8/13 Laparotomy without resection (n = 3)
Right hemicolectomy (n = 4)
Terminal ileal resection (n = 1)
Isolated ileocecal inflammation, edema or pneumatosis without evidence of necrosis or infarction Perforation (5)
Exploratory laparotomy (3)
1/8
5/8 dead at 4 months
Moir 1986 6/16 Right hemicolectomy, ileostomy, and mucous fistula (n = 3)
Divided ileostomy (n = 1)
Local resection, ileostomy, abscess drainage (n = 2)
In all, cecal ulceration and mucosal thickening with intense submucosal and mucosal edema. The more severe cases showed hemorrhagic infarction Severe systemic sepsis
Persistent tenderness, rebound
Pneumatosis
Bowel instruction
Paracolic abcesses
Right flank myonecrosis
2/6
Starnes 1986 5/23 / / Cholecystitis
Right lower quadrant typhlitis
Splenic infarction
Diverticular perforation
Large bowel obstruction
0/5
Villar 1987 18/19 Exploratory laparotomy (n = 4)
Colectomy (n = 3)
Drainage of hepatic abscesses (n = 3)
Enterolysis (n = 3)
Simoid resection (n = 1)
Cholecystectomy (n = 1)
Appendicectomy (n = 1)
Ligation of esophageal varices and splenectomy (n = 1)
Meckel’s resection (n = 1)
/ Enterocolitis (4)
Sepsis (3)
Hepatic abscesses (3)
Bowel obstruction (3)
Cholecystitis (1)
Appendicitis (1)
3/18
Wade 1992 6/22 Appendectomy (n = 2)
No bowel resection (n = 1)
Right hemicolectomy (n = 1)
Diverting colostomy (n = 1)
Cholecystectomy (n = 1)
/ Appendicitis (2)
Digestive hemorrhage (1)
Cecum perforation (1)
Prevention of perineal excoriation (1)
Cholecystitis (1)
3/6
Abbasoglu 1993 2/3 Appendectomy and cecum exteriorization (n = 1)
Laparotomy and sigmoid exteriorization (n = 1)
Ulceration, thrombosed vessels and necrotic areas in the mucosa and submucosa.
Necrosis involving all layers, sigmoid perforation
Appendix perforation
Colon perforation
1/2
Buyukasik 1997 3/20 Bowel resection and enterostomy (n = 3) Ischemic and hemorrhagic mucosal and submucosal necroses extending focally to serosal surface, microvascular thromboses, submucosal edema, bacterial infiltrates with the absence of inflammatory response and necrotic mucosal pseudo-membranes / 0/3
Gomez 1998 1/18 Exploratory laparotomy (n = 1) Edematous and thickened cecum and ascending colon / /
Song 1998 2/14 End jejunostomy and fistula (n = 1)
No bowel resection (n = 1)
Ischemia of the entire small bowel, and right colon most severely involving the distal ileum with focal areas of transmural necrosis.
Thickened inflamed cecum
Medical treatment failure (1)
Peritoneal signs (1)
1/2
Ibrahim 2000 3/6 Right hemicolectomy (n = 1)
Left hemicolectomy (n = 1)
Left hemicolectomy (n = 1)
Necrotic bowel.
Multiple ulcerations of the sigmoid colonic wall and acute and chronic inflammation, acute serositis and perforation. Histologically, extensive ischemic damage was evident, as well as vascular changes, including thrombosis and revascularization associated with mucosal regeneration
Perforation of the descending sigmoid colon. Transmural necrosis associated with perforation was histologically evident
Pneumoperitoneum (2)
Severe abdominal pain (1)
1/3
Cartoni 2001 1/88 Left hemicolectomy (n = 1) Ulceration and hemorrhagic necrosis of the intestinal mucosa in all cases, together with a mild-to-moderate mononuclear inflammatory infiltrate / 0/1
Gorschluter 2002 5/13 Cholecystectomy (n = 2)
Left-sided colostomy (n = 1)
Laparotomy (n = 1)
Appendectomy (n = 1)
Diffuse serous inflammation / 0/5
Kirkpatrick 2003 1/11 Total colectomy (n = 1) Digestive perforation / /
Hsu 2004 2/9 Laparotomy (n = 2) Bowel necrosis and peritonitis / /
Batlle 2007 6/7 Ileocolic resection (n = 1)
Right hemicolectomy with ileostomy (n = 5)
Typhlitis confirmed. Ulcerated mucosa. Massive edema / /
Badgwell 2008 3/17 Right colectomy (n = 2)
Left colectomy (n = 1)
/ / 0/3
Gondal 2010 4/16 / / / /
Mokart 2017 58/58 / / No cause (1)
Primary peritonitis (2)
Tumoral infiltration (12)
Digestive graft versus host disease (2)
NE (3)
Invasive digestive aspergillosis (3)
Digestive bleeding (5)
Appendicitis (2)
Cholecystitis (3)
Sigmoiditis (8)
Gastrointestinal obstruction (8)
Mesenteric ischemia (2)
Others (7)
18/58
Sachak 2015 15/19 Segmental resection (n = 15) Gross mucosal abnormalities with a patchy distribution. Histologic abnormalities always involved the cecum and/or right colon with other bowel segments variably involved. NE lesions were not seen in the appendix or rectum. Pathologic features included necrosis and hemorrhage. Many cases were characterized by infiltrating organisms in an inflammatory depleted background / 4/19
  1. n patients undergoing surgery, n′ total number of patients. NE neutropenic enterocolitis