Kaya Ahmet, Karahan Mahmut Alp
Department of Anesthesiology and Reanimation, University of Health Science, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
BMC Anesthesiol. 2025 Jul 30;25(1):369. doi: 10.1186/s12871-025-03241-5.
Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is used as an effective multimodal treatment option for patients with peritoneal malignancies. In this retrospective study, the anesthetic management of CRS + HIPEC procedures performed in our hospital between 2020 and 2024 and the postoperative course of the patients were investigated.
The present study included 22 patients who underwent CRS + HIPEC at our hospital. Preferred solutions for perioperative fluid management were balanced crystalloid, colloid and albumin. The mean duration of surgery was 326 and the mean duration of anesthesia was 344 min. 72.7% of the patients were female, and 27.3% were male, and the mean age was 58.6 years. ASA 3 score was found in 81.8% of the patients. While 68.2% of the patients did not receive preoperative chemotherapy, 31.8% received chemotherapy.
In the intraoperative period, the mean body temperature increased to 38.1 °C, and 6568 mL of crystalloid and 1325 mL of colloid were used for fluid management. The most prevalent metabolic alterations observed in the postoperative period were hypocalcemia (81.2%), hypokalemia (45.5%) and hyperglycemia (36%). A significant increase in lactate level (1.85 ± 1.93 mmol/L) and a decrease in bicarbonate level (4.12 ± 4.66 mmol/L) were observed after HIPEC. While 22.7% of the patients died in the postoperative period, 77.3% were discharged. Liberal fluid management strategies were employed; however, in recent cases, targeted fluid management has been introduced.
It is imperative to emphasize that individualized fluid management and advanced monitoring during CRS + HIPEC procedure are critical in maintaining hemodynamic balance and reducing complications.
The Study was registered in clinicaltrials.gov (trial ID: NCT06398678 on 03/05/2024).
细胞减灭术（CRS）联合腹腔内热灌注化疗（HIPEC）是用于治疗腹膜恶性肿瘤患者的一种有效的多模式治疗选择。在这项回顾性研究中，我们调查了2020年至2024年期间在我院进行的CRS + HIPEC手术的麻醉管理及患者的术后病程。
本研究纳入了22例在我院接受CRS + HIPEC手术的患者。围手术期液体管理的首选溶液为平衡晶体液、胶体液和白蛋白。手术平均时长为326分钟，麻醉平均时长为344分钟。患者中72.7%为女性，27.3%为男性，平均年龄为58.6岁。81.8%的患者ASA评分为3级。68.2%的患者未接受术前化疗，31.8%的患者接受了化疗。
术中，平均体温升至38.1℃，液体管理使用了6568毫升晶体液和1325毫升胶体液。术后观察到最常见的代谢改变为低钙血症（81.2%）、低钾血症（45.5%）和高血糖（36%）。HIPEC术后观察到乳酸水平显著升高（1.85±1.93毫摩尔/升）和碳酸氢盐水平降低（4.12±4.66毫摩尔/升）。22.7%的患者术后死亡，77.
