ABSTRACT
The association between chemotherapy and hypertermia produces a synergic effect. In this study the Authors present their experience, by the analysis of the results. From 1993 to 2000, 17 patients have been treated with surgery associated with hypertermic chemotherapy for peritoneal carcinomatosis. For the management of these patients a constant cooperation among surgeon, cardiologist and anaesthetist is very important.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma/secondary , Cardiovascular Diseases/etiology , Hyperthermia, Induced/adverse effects , Peritoneal Neoplasms/secondary , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Appendiceal Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoid Tumor/secondary , Carcinoma/drug therapy , Carcinoma/surgery , Carcinoma/therapy , Carcinoma, Ductal, Breast/surgery , Cardiovascular Diseases/physiopathology , Cisplatin/administration & dosage , Cisplatin/adverse effects , Colonic Neoplasms/pathology , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Neoplasm Seeding , Neoplasms, Second Primary , Ovarian Neoplasms/pathology , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/surgery , Peritoneal Neoplasms/therapy , Retrospective Studies , Stomach Neoplasms/pathology , Treatment OutcomeABSTRACT
The literature considers hyperthermic intraoperative intraperitoneal chemotherapy a safe and effective procedure for peritoneal carcinomatosis, but a technical improvement is necessary. Regional chemotherapy anticipates the "downfall" of tumoral cells in the peritoneum. The Authors considered 5 patients--female, age 27-45 years, ASA 2--operated of peritonectomy in ovaric neoplasia with peritoneal metastasis. The hyperthermic intraoperative intraperitoneal chemotherapy has been made at the end of the surgery with a hot solution (43 degrees C): 3000 ml of dextrose 1.5% with mytomicina C 25 mg e cysplatino 75 mg/m2. We considered variation of emodinamic parametres (blood pressure, central venous pressure, stroke volume, etc.) and biochemical parametres (Na, K, CI-, CO2, etc.). These parametres have been correlated with some complications: fistula, anastomotic leakage, pancreatitis and postoperative bleeding.