ABSTRACT

Objectives:

Cytoreductive surgery (SRC) and hyperthermic intraperitoneal chemotherapy (HIPEC) implementation is a prolonged and complex procedure. Major blood and fluid loss, hemodynamic, hematological and metabolic changes are associated with high morbidity and mortality in the perioperative period. In this study, patients who underwent SRC and HIPEC in our operating room were retrospectively analyzed.

Materials and Methods:

The files of 26 patients who underwent SRC and HIPEC were reviewed retrospectively. Preoperative, intraoperative and postoperative records were examined, blood/blood product and fluid replacements, metabolic changes, postoperative complications, length of stay in intensive care and hospital and mortality rates were evaluated.

Results:

There were 26 patients included in the study, 7 of them were male and 19 were female. The primary diagnoses of the patients were ovarian cancer (42.3%), colorectal cancer (15.3%), malignant peritoneal mesothelioma (15.3%), pseudomyxoma peritonei (11.5%) and other malignant diseases (15.3%). There was a decrease in postoperative hemoglobin, hematocrit, platelet and albumin values compared to preoperative values (p<0.05). Ca, K, Mg values decreased, glucose, Cl and Na values increased (p<0.05). Grade 3-5 complications according to the Clavien-Dindo classification were observed in eight patients in the postoperative period. The presence of peritoneal cancer index and acute kidney injury was found to be a risk factor for the development of 3-5-degree complications (p<0.05). The mean operation time was 250.5±74.4 minutes. The mean length of stay in the ICU was 34.5±15.4 hours. The mean length of hospital stay was 11.2±9.5 days.

Conclusion:

It is aimed to improve survival and quality of life with SRC and HIPEC. However, electrolyte and metabolic disorders with severe fluid, blood and protein losses may develop in the perioperative period. Laboratory values and hemodynamic parameters should be closely monitored to improve patient outcomes.

Keywords: Cytoreductive Surgery, Hyperthermic Intraperitoneal Chemotherapy, Perioperative Outcomes

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Anesthesia Management and Perioperative Outcomes in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

ABSTRACT

References