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Anesthesiological support of cytoreducative operations using hyperthermic intraperitoneal chemotherapy (hipec) in patients with ovaryan cancer

https://doi.org/10.21292/2078-5658-2019-16-5-24-30

Abstract

The objective of the study: to analyze the experience of anesthesia when performing cytoreductive surgeries using hyperthermic intraperitoneal chemotherapy in patients with advanced forms of ovarian cancer.

Subjects and methods. A pilot study of anesthetic management was conducted in 30 patients with ovarian cancer who underwent multiorgan cytoreductive abdominal resection with hyperthermic intraperitoneal chemotherapy.

Results. The risk of anesthesia was 5.18 ± 0.39 points (which corresponded to the III degree of risk) according to the recommendations of the Moscow Scientific Society of Anesthesiology Reanimatology (MSSAR). The total volume of infusion‒transfusion therapy (ITT) was 11.070,0 ± 2.243,5 ml. with the hour rate of 21.7 ± 6.1 ml/kg-1/h-1, due to increase in the volume of crystalloids. Important components of anesthetic management were the patient's thermal stability and antiemetic therapy.

Conclusion. As a result of the study, it was revealed that anesthesia in patients during cytoreductive operations with HIPEC was fairly complex and required the participation of a well-trained anesthesiological team. The issue of choosing the scale to assess anesthetic risk due to the lack of optimal one for this type of operations, requires further research. Although in our opinion, the scale of anesthesiological risk of the Moscow Scientific Society of Anesthesiologists-Resuscitators is more preferable. In such operations, the volume of ITT should be increased primarily through balanced crystalloids.

About the Authors

D. D. Morikov
Irkutsk State Medical Academy of Postgraduate Education - Branch of Russian Medical Academy of Continuing Professional Education; Regional Oncology Dispensary; Irkutsk State Medical University
Russian Federation

Dmitry D. Morikov - Candidate of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department.

100, Yubileyny R.D., Irkutsk, 664049

Phone: +7 (3952) 46‒53‒26.



A. V. Shelekhov
Irkutsk State Medical Academy of Postgraduate Education - Branch of Russian Medical Academy of Continuing Professional Education; Regional Oncology Dispensary; Irkutsk State Medical University
Russian Federation

Aleksey V. Shelekhov - Doctor of Medical Sciences, Professor of Oncology and Radiation Therapy Department.

100, Yubileyny R.D., Irkutsk, 664049

Phone: +7 (3952) 46‒53‒26.



V. I. Gorbachev
Irkutsk State Medical Academy of Postgraduate Education - Branch of Russian Medical Academy of Continuing Professional Education
Russian Federation

Vladimir I. Gorbachev - Doctor of Medical Sciences, Professor, Head of Anesthesiology and Intensive Care Department.

100, Yubileyny R.D., Irkutsk, 664049

Phone: +7 (3952) 46‒53‒26.



V. V. Dvornichenko
Irkutsk State Medical Academy of Postgraduate Education - Branch of Russian Medical Academy of Continuing Professional Education; Regional Oncology Dispensary
Russian Federation

Viktoriya V. Dvornichenko - Doctor of Medical Sciences, Professor, Head of Oncology and Radiation Therapy Department.

100, Yubileyny R.D., Irkutsk, 664049

Phone: +7 (3952) 46‒53‒26.



A. G. Pavlov
Regional Oncology Dispensary
Russian Federation

Aleksandr G. Pavlov - Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Department no. 4.

32, Frunze St., Irkutsk, 664035.

Phone: +7 (3952) 21‒42‒20.



S. I. Radostev
Irkutsk State Medical Academy of Postgraduate Education - Branch of Russian Medical Academy of Continuing Professional Education; Regional Oncology Dispensary
Russian Federation

Sergey I. Radostev - Oncologist of Coloproctology Department.

32, Frunze St., Irkutsk, 664035.

Phone: +7 (3952) 21‒42‒20.



I. I. Osadchiy
Irkutsk State Medical University
Russian Federation

Ilya I. Osadchiy - Student of the VIth year of Training, General Medicine Department.

1, Krasnogo Vosstaniya St., Irkutsk, 664003.

Phone: +7 (3952) 24‒38‒25.



T. G. Zyabreva
Irkutsk State Medical University
Russian Federation

Tatiana G. Zyabreva - Student of the VIth year of Training, General Medicine Department.

1, Krasnogo Vosstaniya St., Irkutsk, 664003.

Phone: +7 (3952) 24‒38‒25.



References

1. Аksel E.M., Vinogradova N.N. Statistics of malignant neoplasms of female reproductive organs. Onkoginekologiya, 2018, no. 3, pp. 64‒78.(In Russ.)

2. Smeshnoy I.А., Pasechnik I.N., Skobelev E.I. et al. Optimization of infusion therapy in elective abdominal surgery. Obschaya Reanimatologiya, 2018, vol. 14, no. 5, pp. 4‒15. (In Russ.)

3. Lechenie zlokachestvennykh opukholey. Rukovodstvo dlya vrachey. [Treatment of malignant tumors. Doctor's handbook]. Belyaev А.M., Leontiev O.V., Rogachev M.V., eds., St. Peterburg, SpetsLit. Publ., 2018, 286 p.

4. Khoronenko V.E., Shemetova M.M., Drozhzhina O.V. et al. Anesthetic management and intensive care during hyperthermic intraoperative intraabdominal chemotherapy in patients with gastric cancer. Literature review and own clinical experience. Anesteziologiya i Reanimatologiya, 2015, vol. 60, no. 1, pp. 50-54. (In Russ.)

5. Shelekhov А.V., Dvornichenko V.V., Radostev S.I. et al. Experience in the application of cytoreductive surgery technology with the method of intraoperative intraperitoneal hyperthermic chemotherapy in the treatment of patients with advanced ovarian cancer. Sibirsky Onkologicheskiy Journal, 2018, vol. 17, no. 3, pp. 58-63. (In Russ.)

6. Bakrin N., Classe J.M., Pomel C. et al. Hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer. J. Vis. Surg., 2014, vol. 151, no. 5, pp. 347‒353.

7. Cata J.P., Zavala A.M., Van Meter A. et al. Identification of risk factors associated with postoperative acute kidney injury after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a retrospective study. Intern. J. Hyperthermia, 2018, vol. 34, no. 5, pp. 538‒544.

8. Colantonio L., Claroni C., Fabrizi L. et al. A randomized trial of goal direct vs standart fluid therapy in cytoreductive surgery with hiperthermic intraperitoneal chemotherapy. J. Gastrointest. Surg., 2015, no. 19, pp. 722.

9. De Brito Poveda V., Clark A.M., Galvão C.M. A systematic review on the effectiveness of prewarming to prevent perioperative hypothermia. J. Clin. Nurs., 2013, vol. 22, no. 7-8, pp. 906‒918.

10. Esteve-Perez N., Ferrer-Robles A., Gomez-Romero G. et al. Goal-directed therapy in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a prospective observational study. Clin. Transl. Oncol., 2018, https://doi.org/10/1007/s12094-018-1944- (First Online: 14 September 2018).

11. Iavazzo C., Spiliotis J. Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer: a "useless intraoperative fever" or the next hot voice in the surgical management of the "silent killer"? Arch. Gynecol. Obstet., 2018, vol. 298, no. 4, pp. 673‒674.

12. I-Lin E.S., Shulyn C.C., Hwei Ching G.T. et al. Acute kidney injury in ovarian cancer patients undergoing cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy. Intern. J. Hyperthermia, 2017, vol. 33, no. 6, pp. 690‒695.

13. Morales-Soriano R., Esteve-Perez N., Segura-Sampedro J.J. et al. Spanish Group of Peritoneal Malignancy Surface (GECOP). Current practice in cytoreductive surgery and HIPEG for metastatic peritoneal disease: Spanish multicentric survey. Eur. J. Surg. Oncology, 2018, vol. 44, issue 2, pp. 228‒236.

14. Raspe C., Fletcher L., Schneider R. et al. Best practice for perioperative management of patients with cytoreductive surgery and HIPEG. Eur. J. Surg. Oncology, 2017, vol. 43, issue 6, pp. 1013‒1027. https://doi.org/10.1016/j.ejso.2016.19.008

15. Sugarbaker P.H. Evolution of cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis: are there treatment alternatives? Am. J. Surg., 2011, vol. 201, pp. 157-159.


Review

For citations:


Morikov D.D., Shelekhov A.V., Gorbachev V.I., Dvornichenko V.V., Pavlov A.G., Radostev S.I., Osadchiy I.I., Zyabreva T.G. Anesthesiological support of cytoreducative operations using hyperthermic intraperitoneal chemotherapy (hipec) in patients with ovaryan cancer. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2019;16(5):24-30. (In Russ.) https://doi.org/10.21292/2078-5658-2019-16-5-24-30



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ISSN 2078-5658 (Print)
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