Security and efficiency of a closed-system, turbulent-flow circuit for hyperthermic intraperitoneal chemotherapy after cytoreductive ovarian surgery: perioperative outputs
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To present physiologic intraoperative data and immediate postoperative outcomes of patients diagnosed with epithelial ovarian cancer submitted to cytoreductive surgery and hyperthermic peritoneal intraoperative chemotherapy (HIPEC) with a closed-circuit, turbulent-flow system.
Materials and methods
A closed-circuit system with CO2 turbulent flow was used for paclitaxel HIPEC during 60 min for patients diagnosed with stage II or higher and recurrent epithelial ovarian cancer. Perioperative hemodynamic and metabolic statuses were followed, as well as physiologic recovery during the first 12 postoperative hours. A non-parametric statistical analysis was performed.
At the end of the hyperthermia phase, temperature was 37.7 ± 0.6 °C, heart rate 88 ± 19 bpm, cardiac index 2.8 ± 0.5 L min−1 m−2, stroke volume variation 14.6 ± 3.6 % and extravascular lung water 8.7 ± 1.9 mL kg−1. No hyperdynamic status was recorded. The length of stay in the ICU was 2½ days, and 12.7 ± 7 days in hospital. Average postoperative intubation time was 11.7 ± 17.4 h. At the ICU admission time, glucose, lactic acid and hemoglobin were the only values out of range, but close to normal. SOFA median was 3 at admission and 0 the following day.
A turbulent-flow, closed-circuit use for hyperthermic peritoneal intraoperative chemotherapy resulted in no hyperdynamic response or coagulopathy, had good tolerance and promoted early physiologic recovery.
KeywordsEpithelial ovarian cancer Hyperthermic intraperitoneal chemotherapy Intraoperative outputs Postoperative outcomes
Conflict of interest
Dr Villarejo has a Government grant for a Clinical Trial to compare plain surgery with surgery plus intraoperative hyperthermic paclitaxel chemotherapy. The device we used for this pilot series is the Combat PRS™ (Peritoneum Recirculation System, Galmaz Biotech, Madrid, Spain), borrowed at no cost by the owner.
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