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Does hyperthermia induce peritoneal damage in continuous hyperthermic peritoneal perfusion?

A Shido1, S Ohmura, K Yamamoto

  • 1Department of Anesthesiology, Tatsunokuchi Houju Memorial Hospital, Tatsunokuchi-machi, Nomi-gun, Japan.

World Journal of Surgery
|April 29, 2000
PubMed
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Continuous hyperthermic peritoneal perfusion (CHPP) does not cause peritoneal damage. Peritoneal damage is linked to anticancer drugs used in perfusion, not hyperthermia itself, in advanced gastric cancer patients.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Peritoneal Dialysis

Background:

  • Continuous hyperthermic peritoneal perfusion (CHPP) is used in treating advanced gastric cancer.
  • The mechanisms of peritoneal damage induced by CHPP require further investigation.

Purpose of the Study:

  • To investigate the mechanisms of peritoneal damage caused by CHPP.
  • To compare protein and fluid loss during and after CHPP versus continuous normothermic peritoneal perfusion (CNPP).

Main Methods:

  • Sixteen advanced gastric cancer patients underwent peritoneal perfusion therapy with cisplatin and mitomycin C.
  • Patients were divided into CHPP (n=9) and CNPP (n=7) groups, with perfusate temperatures of 42.0°C and 37.0°C, respectively.
  • Protein and fluid loss were measured during and after perfusion, and via abdominal drains post-surgery.

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Main Results:

  • No significant differences in patient characteristics were observed between CHPP and CNPP groups, except for perfusate temperature.
  • Protein loss into the perfusate and fluid/protein loss through drains were not significantly different between the groups.
  • No significant differences in postoperative protein and fluid loss were found between the CHPP and CNPP groups over 3 days.

Conclusions:

  • Peritoneal damage associated with CHPP in advanced gastric cancer patients is not primarily caused by hyperthermia.
  • The peritoneal damage is attributed to the perfusion with saline solution containing anticancer drugs, rather than the elevated temperature.
  • This finding suggests that the chemotherapeutic agents are the main contributors to peritoneal injury during perfusion therapy.