Anesthetic management in an appendix tumor patient undergoing hyperthermic chemotherapy

Abstract

Cytoreductive surgery combined with hyperthermic intra­peritoneal chemotherapy (HIPEC) is a complex and mul­tidiscipliner procedure that is being used increasingly for peritoneal and appendix malignency. First of all the mac­roscopic tumor tissues are extracted after that peritoneal perfusion is started with giving heated 42°C chemother­apeutic solution via abdominal drains. It is important to maintain normovolemia, to regulate coagulation and renal parameters during perioperative period, to compansate hypothermia during cytoreductive surgery and hyperther­mia during HIPEC and to regulate hemodynamic changes due to increased abdominal pressure during HIPEC. In this case report, we aimed to share anaesthetic experi­ence and to evaluate anaesthetic problems in 45 years old ASA I patient undergoing cytoreductive surgery and hypertermic intraperitoneal chemotherapy in which newly established in our hospital for appendix tumor. J Clin Exp Invest 2013; 4 (2): 234-237

Keywords

• Anaesthesia, general, hyperthermic intraper­itoneal chemotherapy, cytoreductive surgery.

Hipertermik kemoterapi uygulanan apandis tümörü hastasında anestezik yaklaşım

Öz

Sitoredüktif cerrahi ile birlikte uygulanan hipertermik intra­peritoneal kemoterapi (HİPEK), peritoneal ve apandise ait malignitelerde gittikçe artan oranda kullanılan, kompleks ve multidisipliner bir yöntemdir. Önce görülebilen bütün tümör dokuları çıkarılır, daha sonra 42°C\'ye ısıtılmış ke­moterapötik solüsyon, drenler yolu ile batına verilerek pe­ritoneal perfüzyon yapılır. Perioperatif dönemde normo­voleminin sürdürülmesi, sitoredüktif faz sırasında hipoter­minin, HİPEK sırasında hiperterminin kompanse edilmesi ve intraabdominal basıncın artmasına bağlı ortaya çıkan hemodinamik değişikliklerin regüle edilmesi, koagülasyon ve renal parametrelerin takip edilerek düzeltilmesi önem­lidir. Biz de nüks apandis müsinöz tümörü nedeniyle sitoredük­tif cerrahi ve HİPEK planlanan 45 yaşındaki ASA I erkek hastamız nedeniyle, hastanemizde yeni yapılmaya başla­nan bu yöntem konusundaki deneyimimizi paylaşmayı ve anestezi açısından oluşabilecek sorunları gözden geçir­meyi amaçladık.

Anahtar Kelimeler

• Anestezi, genel; hipertermik intrape­ritoneal kemoterapi; sitoredüktif cerrahi.

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