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[Perioperative management for CRS and HIPEC : Anesthesiological aspects]
D Bleiler1, S Bleiler2, B Sinner1
1Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
Der Anaesthesist
|December 11, 2019
Summary
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) treats abdominal cancers, improving patient survival. Anesthesia management is critical due to significant physiological changes during this complex procedure.
Area of Science:
- Oncology
- Surgical Oncology
- Anesthesiology
Background:
- Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment for intra-abdominal neoplasms.
- This procedure involves resecting visible tumors followed by chemotherapy to eliminate microscopic disease.
- CRS with HIPEC can enhance patient quality of life and survival rates.
Purpose of the Study:
- To highlight the complex nature of CRS with HIPEC.
- To identify key anesthetic challenges, including fluid shifts and metabolic changes.
- To emphasize the importance of preoperative optimization for high-comorbidity patients.
Main Methods:
- Review of the CRS with HIPEC procedure.
- Analysis of perioperative physiological changes.
- Focus on anesthetic management strategies.
Main Results:
- CRS with HIPEC is a complex procedure associated with significant pathophysiological alterations.
- Anesthetic concerns include massive volume loss, fluid shifts, and metabolic disturbances.
- Preoperative optimization is crucial for patients with high comorbidity.
Conclusions:
- CRS with HIPEC offers survival benefits for intra-abdominal neoplasms.
- Careful anesthetic management is essential to mitigate perioperative risks.
- Optimizing patients preoperatively can reduce morbidity and mortality in complex interventions.
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