Gupta Nishkarsh, Kumar Vinod, Garg Rakesh, Bharti Sachidanand Jee, Mishra Seema, Bhatnagar Sushma
Department of Onco-Anesthesiology and Palliative Medicine, DR BRAIRCH, AIIMS, New Delhi, India.
J Anaesthesiol Clin Pharmacol. 2019 Jan-Mar;35(1):3-11. doi: 10.4103/joacp.JOACP_93_18.
Patients with peritoneal carcinomatosis were considered incurable with dismal survival rates till hyperthermic intraperitoneal chemotherapy after optimal cytoreductive surgery evolved. Perioperative management for these procedures is complex and involves an optimal cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy. In this article we highlight the perioperative concerns in these patients including anesthetic challenges, such as optimal fluid management, maintaining blood pressure, control of body temperature, coagulation and electrolyte derangement and renal toxicity of chemotherapeutic drugs. We have also discussed the postoperative problems and their management.
在最佳细胞减灭术后的腹腔内热化疗出现之前，腹膜癌转移患者被认为无法治愈，生存率极低。这些手术的围手术期管理很复杂，包括先进行最佳细胞减灭术，然后进行腹腔内热化疗。在本文中，我们重点介绍了这些患者围手术期需要关注的问题，包括麻醉方面的挑战，如优化液体管理、维持血压、控制体温、凝血和电解质紊乱以及化疗药物的肾毒性。我们还讨论了术后问题及其处理方法。
