title: An overview of cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion for the anesthesiologist.
abstract: Anesthesiologists face several perioperative challenges when patients need cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion. To adequately care for these patients, anesthesiologists must understand the goals and objectives of the operation in addition to having a basic knowledge of the chemotherapeutic drugs that are frequently used. Optimal anesthetic management of patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion requires control of a complex interplay of physiologic mechanisms, including hyperthermia, abdominal hypertension, electrolyte abnormalities, coagulopathies, increased cardiac index, oxygen consumption, and decreased systemic vascular resistance. As this surgery continues to gain popularity among oncologic surgeons, further studies that clearly define the chemistry, pharmacokinetics, pharmacodynamics, and end points of efficacy need to be performed to elucidate optimal perioperative management.
authors: Department of Anesthesiology, Columbia University College of Physicians & Surgeons, Columbia University Medical Center, New York, NY 10032, USA.
authors: Christopher Allen-John
authors: CA
authors: Webb
authors: Paul David
authors: PD
authors: Weyker
authors: Vivek K
authors: VK
authors: Moitra
authors: Richard K
authors: RK
authors: Raker
mesh_terms: D000758:Anesthesia; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003131:Combined Modality Therapy; D006801:Humans; D006979:Hyperthermia, Induced; D007430:Intraoperative Care; D016272:Occupational Health; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents