Kerscher, Christoph and Ried, Michael and Hofmann, Hans-Stefan and Graf, Bernhard M. and Zausig, York A. (2014) Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion. JOURNAL OF CARDIOTHORACIC SURGERY, 9: 125. ISSN 1749-8090,
Full text not available from this repository. (Request a copy)Abstract
Background: Macroscopic cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion (HITHOC) is a new multimodal approach for selected patients with primary and secondary pleural tumors, which may provide the patient with better local tumor control and increased overall survival rate. Methods: We present a single-center study including 20 patients undergoing cytoreductive surgery and HITHOC between September 2008 and April 2013 at the University Medical Center Regensburg, Germany. Objective of the study was to describe the perioperative, anaesthetic management with special respect to pain and complication management. Results: Anaesthesia during this procedure is characterized by increased intrathoracic airway and central venous pressure, hemodynamic alterations and the risk of systemic hypo-and hyperthermia. Securing an adequate intravascular volume is one of the primary goals to prevent decreased cardiac output as well as pulmonary edema. Transfusion of packed red blood cells (PRBC) was necessary in seven of 20 (35%) patients. Only two patients (10%) showed an impairment of coagulation in postoperative laboratory analysis. Perioperative forced diuresis is recommended to prevent postoperative renal insufficiency. Supplementary thoracic epidural analgesia in 13 patients (65%) showed a significant reduction of post-operative pain compared with peroral administration of opioid and non-opioid analgesics. Conclusion: This article summarizes important experiences of the anaesthesiological and intensive care management in patients undergoing HITHOC.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MALIGNANT PLEURAL MESOTHELIOMA; INTRAPERITONEAL CHEMOTHERAPY; EXTRAPLEURAL PNEUMONECTOMY; PERITONEAL CARCINOMATOSIS; PERIOPERATIVE MANAGEMENT; MULTIMODALITY TREATMENT; CLINICAL-EXPERIENCE; LUNG INJURY; CISPLATIN; PLEURECTOMY/DECORTICATION; Anaesthetic management; Cytoreductive surgery; Hyperthermic intrathoracic chemotherapy perfusion; Thoracic epidural analgesia; One lung ventilation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Sep 2019 12:13 |
| Last Modified: | 12 Sep 2019 12:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/9864 |
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