title: Pulmonary influences on early post-operative recovery in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: a retrospective study.
abstract: BACKGROUND
  The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a curative treatment option for peritoneal carcinomatosis (PC). There have been few studies on the pulmonary adverse events (AEs) affecting patient recovery after this treatment, thus this study investigated these factors.
  
  
  METHODS
  Between January 2005 and December 2006, clinical data on all pulmonary AEs and the recovery progress were reviewed for 76 patients with after CRS and HIPEC. Patients with pulmonary interventions (thoracocenthesis and chest tubes) were compared with the non-intervention patients. Two senior radiologists, blinded to the post-operative clinical course, separately graded the occurrence of pulmonary AEs.
  
  
  RESULTS
  Of the 76 patients, 6 had needed thoracocentesis and another 6 needed chest tubes. There were no differences in post-operative recovery between the intervention and non-intervention groups. The total number of days on mechanical ventilation, the length of stay in the intensive care unit, total length of hospital stay, tumor burden, and an American Society of Anesthesiologists (ASA) grade of greater than 2 were correlated with the occurrence of atelectasis and pleural effusion. Extensive atelectasis (grade 3 or higher) was seen in six patients, major pleural effusion (grade 3) in seven patients, and signs of heart failure (grade 1-2) in nine patients.
  
  
  CONCLUSIONS
  Clinical and radiological post-operative pulmonary AEs are common after CRS and HIPEC. However, most of the pulmonary AEs did not affect post-operative recovery.
authors.affiliation: Department of Surgical Sciences, Section of Surgery, Uppsala University, Uppsala, Sweden. erebouni.arakelian@surgsci.uu.se
authors.forename: Erebouni
authors.initials: E
authors.lastname: Arakelian
authors.forename: Michael R
authors.initials: MR
authors.lastname: Torkzad
authors.forename: Antonina
authors.initials: A
authors.lastname: Bergman
authors.forename: Sten
authors.initials: S
authors.lastname: Rubertsson
authors.forename: Haile
authors.initials: H
authors.lastname: Mahteme
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002277:Carcinoma / Q000150:complications / Q000473:pathology / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects*; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D007263:Infusions, Parenteral; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents