Intensive Care Unit Admission after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Is It Necessary?

Abstract EN

Introduction.

Cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a new approach for peritoneal carcinomatosis.

However, high rates of complications are associated with CS and HIPEC due to treatment complexity; that is why some patients need stabilization and surveillance for complications in the intensive care unit.

Objective.

This study analyzed that ICU stay is necessary after HIPEC.

Methods.

39 patients with peritoneal carcinomatosis were treated according to strict selection criteria with CS and HIPEC, with closed technique, and the chemotherapy administered were cisplatin 25 mg/m2/L and mitomycin C 3.3 mg/m2/L for 90-minutes at 40.5°C.

Results.

26 (67%) of the 39 patients were transferred to the ICU.

Major postoperative complications were seen in 14/26 patients (53%).

The mean time on surgical procedures was 7.06 hours (range 5−9 hours).

The mean blood loss was 939 ml (range 100–3700 ml).

The mean time stay in the ICU was 2.7 days.

Conclusion.

CS with HIPEC for the treatment of PC results in low mortality and high morbidity.

Therefore, ICU stay directly following HIPEC should not be standardized, but should preferably be based on the extent or resections performed and individual patient characteristics and risk factors.

Late complications were comparable to those reported after large abdominal surgery without HIPEC.