[Prevention of scald injury due to intraperitoneal hyperthermic perfusion for far-advanced gastric cancer]

In an attempt to prevent scald injury on the peritoneo-serosal surface due to intraperitoneal hyperthermic perfusion (IPHP) for far-advanced gastric cancer patients, a histamine H2-receptor antagonist, cimetidine, was prescribed for 9 patients. The IPHP treatment was carried out with a closed circuit using a heated perfusate, and intra-abdominal temperature was kept over 44 degrees C throughout IPHP, for 120 minutes. Of 18 patients given IPHP, 9 were administered intravenously cimetidine at a dose of 50 mg/kg just before IPHP (cimetidine group) and the remaining 9 were prescribed IPHP and not given cimetidine (control group). Amounts of exudate and protein from peritoneal cavity and serum histamine were compared between the two groups. The amount of intra-abdominal exudate was 768 +/- 95 ml for 24 hours in the control group, against 408 +/- 75 ml in the cimetidine group. The protein amounts in exudate throughout IPHP were 62.5 +/- 23.5 g in the control group, against 15.9 +/- 5.4 g in teh cimetidine group. Both the exudate and protein amounts were significantly decreased in the cimetidine group, compared with the controls (p = 1.416 x 10(-7), p = 5.358 x 10(-5)). Serum histamine levels in the cimetidine group increased 2.5 to 6.5 fold for over 12 hours after IPHP, compared to those in the control group. These findings suggest that cimetidine suppresses scald injury on the peritoneo-serosal surface by competitive inhibition with histamine. Consequently, histamine originated from the scald region was released into the circulating blood. Thus, cimetidine helped to prevent thermal injury due to the IPHP.