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Journal of Cardiothoracic Surgery

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Open Access 01-12-2014 | Research article

Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion

Authors: Christoph Kerscher, Michael Ried, Hans-Stefan Hofmann, Bernhard M Graf, York A Zausig

Published in: Journal of Cardiothoracic Surgery | Issue 1/2014

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.

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Title: Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion
Authors: Christoph Kerscher
Michael Ried
Hans-Stefan Hofmann
Bernhard M Graf
York A Zausig
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2014
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/1749-8090-9-125

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anaesthetic management of cytoreductive surgery followed by hyperthermic intrathoracic chemotherapy perfusion

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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