Perioperative Management of Patients Undergonig Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

摘要

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy procedure have demonstrated their efficacy in treating patients with diffused peritoneal carcinomatosis. As a counterpart patients face major and life threatening derangements of their hemodynamic, respiratory and metabolic physiologic balance during the surgery and in the immediate postoperative period. All these derangements demonstrated to be mild and short-lived in the majority of patients when timely addressed. Anesthesiologists, intensive care physicians and surgeons are involved in providing surveillance and organ support till the patient is effectively weaned after the operation. Moreover they are involved in pain control, metabolic and nutritional support. A malnourished state is common due to wasting syndrome from the tumor, difficult feeding and massive ascites. Lastly physicians need to be aware of the quality of life impact of this procedure.