Perioperative anaesthetic management in cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC): a retrospective analysis in a single tertiary care cancer centre
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作者:
Gupta, Raghav
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Gupta, Raghav
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Gupta, Nishkarsh
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Gupta, Nishkarsh
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Sirohiya, Prashant
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Sirohiya, Prashant
[1
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Pandit, Anuja
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Pandit, Anuja
[1
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Ratre, Brajesh Kumar
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Ratre, Brajesh Kumar
[1
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Vig, Saurabh
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Vig, Saurabh
[1
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Bhan, Swati
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Bhan, Swati
[1
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Singh, Ram
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Singh, Ram
[1
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Kumar, Balbir
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Kumar, Balbir
[1
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Bhopale, Shweta
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Bhopale, Shweta
[1
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Mishra, Seema
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Mishra, Seema
[1
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Garg, Rakesh
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Garg, Rakesh
[1
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Bharati, Sachidanand Jee
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Bharati, Sachidanand Jee
[1
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Kumar, Vinod
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Kumar, Vinod
[1
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Deo, Suryanarayana
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All India Inst Med Sci, Dept Surg Oncol, New Delhi, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Deo, Suryanarayana
[2
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Bhatnagar, Sushma
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AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, IndiaAIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
Bhatnagar, Sushma
[1
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机构:
[1] AIIMS, Dept Oncoanesthesia & Palliat Med, New Delhi 110029, India
[2] All India Inst Med Sci, Dept Surg Oncol, New Delhi, India
Objectives: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with increased morbidity and mortality. We retrospectively analysed the perioperative anesthetic management in patients undergoing HIPEC surgery. Methods: After ethics approval, we reviewed the records of patients who underwent CRS/HIPEC from 2015 until 2020. We noted the peritoneal carcinomatosis index (PCI), blood loss, anastomoses done, total amount of fluid given, delta temperature and duration of surgery. These were correlated with the need for postoperative ventilation, length of ICU stay, Clavien-Dindo score and 30 day mortality. Results: Of the 180 patients reviewed, the majority were women (85%) with a mean age of 48 years who had ovarian tumors (n=114). The total amount of fluid given was associated with an increased length of ICU stay (p=0.008). Prolonged surgery resulted in increased length of ICU stay (p<0.001), need for postoperative ventilation (p=0.006) and a poor Clavien-Dindo score (p=0.039). A high PCI score correlated with increased ICU stay, 30 day mortality (p<0.001), and the need for postoperative ventilation (0.005). Conclusions: PCI, duration of surgery and blood loss were major predictors of postoperative morbidity. Additionally, the amount of fluid given and delta temperature affected patient outcome and should be individualized to the patient's needs.