Volume : VII, Issue : VII, July - 2017

Anesthetic management of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy procedures

Sujana Reddy, Harshal Dholke, C Naresh Kumar Reddy

Abstract :

 Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy procedure are done  with increasing frequency to treat patients with diffused peritoneal mucinomatosis or carcinomatosis. These procedures have showed  increased  life expectancy in what was previously considered a “terminal condition”. These patients face major and life threatening derangements of their hemodynamic, respiratory and metabolic physiologic balance during the surgery and in the immediate postoperative period. Despite the need of an advanced organ monitoring and support these perioperative  derangements seem to be mild and short–lived when timely addressed, at least in the majority of patients. Intensive care physicians are involved in providing surveillance and organ support till the patient is effectively weaned after the operation. Moreover, the anesthesiologist as perioperative physician is involved in pain control, metabolic and nutritional support of this cohort of patients. This task can be challenging considering that major cohort of the patients are already on a long list of pain control medication after previous surgery or chemotherapy. A malnourished state is common  and it is secondary to difficult feeding, wasting syndrome from the tumor and massive ascites. The last issue the anesthesiologists need to be aware of is the impact over the quality of life (QoL) of this procedure. The patient’s underlying pathology is unlikely to be definitively cured so no treatment is an acceptable choice. The possibility to withhold the treatments must be part of the consultation process like the discussion about the QoL in the immediate, as well as in the long–term, after the operation. Careful monitoring and treatment of every aspect which can impact the QoL must be taken and the efforts to preserve the QoL must be doubled when compared with a patient scheduled for major abdominal surgery.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Sujana Reddy, Harshal Dholke, C Naresh Kumar Reddy, Anesthetic management of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy procedures, INDIAN JOURNAL OF APPLIED RESEARCH : Volume‾7 | Issue‾7 | July‾2017

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