title: Factors influencing early postoperative recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
abstract: BACKGROUND
  Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can prolong survival in selected patients with peritoneal carcinomatosis (PC). However, there is little data on patients' recovery process after this complex treatment. This study aimed to describe the in-hospital postoperative recovery and factors related to the recovery of patients who undergo CRS and HIPEC.
  
  
  METHODS
  A retrospective audit of the electronic health record (EHR) was undertaken for 76 PC patients (42 women, 34 men) treated primarily with CRS and HIPEC between 2005 and 2006 in Sweden.
  
  
  RESULTS
  Oral intake, regaining bowel functions and mobilisation usually occurred between 7 and 11 days postoperatively. Patients experienced nausea for up to 13 days postoperatively. Forty-two patients were satisfied with their pain management, which usually took the form of epidural anaesthesia and which continued for about one week post-surgery. Sleep disturbance was observed in 51 patients and psychological problems in 49 patients during the first three postoperative weeks. Tumour burden, stoma formation, use of CPAP, primary diagnosis, and the length of stay in the ICU were factors related to an early recovery process.
  
  
  CONCLUSIONS
  Drinking, eating, regaining bowel functions and mobilisation were re-established within 11 days of CRS and HIPEC. Tumour burden, stoma formation, use of CPAP, primary diagnosis and the length of stay in the ICU all had an impact on postoperative recovery, and should be discussed with the patients preoperatively and taken into consideration in designing an individualised patient care plan, in order to attain a more efficient recovery.
authors.affiliation: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. erebouni.arakelian@surgsci.uu.se
authors.forename: E
authors.initials: E
authors.lastname: Arakelian
authors.forename: L
authors.initials: L
authors.lastname: Gunningberg
authors.forename: J
authors.initials: J
authors.lastname: Larsson
authors.forename: K
authors.initials: K
authors.lastname: Norlén
authors.forename: H
authors.initials: H
authors.lastname: Mahteme
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007150:Immunohistochemistry; D007813:Laparotomy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult