Cytoreduction and Hyperthermic Intrathoracic Chemotherapy for Metastatic Pseudomyxoma Peritonei

Pleural extension of pseudomyxoma peritonei is rare, and treatment demands multidisciplinary care. Perioperative management during cytoreductive surgery and hyperthermic intrathoracic chemotherapy challenges anesthesiology and surgical teams in unique ways. Hemodynamic, arrhythmogenic, ventilatory, fluid balance, acid-base, and nephroprotection issues are important considerations. The use of cytoreductive surgery and hyperthermic intrathoracic chemotherapy for extraperitoneal pseudomyxoma peritonei is an innovative and potentially curative approach. Here, we describe our approach to managing these patients.