title: Safe temperature range for intraoperative and early postoperative continuous hyperthermic intraperitoneal perfusion in a swine model of experimental distal gastrectomy with Billroth II reconstruction.
abstract: BACKGROUND
  The current study sought to investigate the safety of intraoperative and early postoperative continuous hyperthermic intraperitoneal perfusion (IEPCHIP) at different temperatures in a swine model of experimental distal gastrectomy with Billroth II reconstruction.
  
  
  METHODS
  Thirty pigs were randomly divided into 5 groups. Two groups were used as the control groups (groups A1 and A2), and 3 groups were used as the perfusion groups (groups B, C and D). Pigs in group A1 received distal gastrectomy with Billroth II reconstruction only. Pigs in groups A2, B, C and D received the same surgery as group A1, followed by IEPCHIP at 37 ± 0.5°C, 42.5 ± 0.5°C, 43.5 ± 0.5°C or 44.5 ± 0.5°C, respectively. The perfusion time was assessed for each pig in group A2 as well as in the perfusion groups, and the perfusions were performed twice for each group. The first perfusion was conducted intraoperatively, and the second perfusion was initiated 1 day after surgery. Data concerning vital signs and hepatic and renal function were collected. Parameters concerning anastomotic healing, the pathology of the anastomotic tissue and abdominal adhesion were compared.
  
  
  RESULTS
  The vital signs and hepatic and renal functions of the pigs in groups A1, A2, B and C were not significantly affected by this procedure. In contrast, the vital signs and hepatic and renal functions of the pigs in group D were significantly affected. Compared to the pigs in groups A1, A2 or B, the anastomotic bursting pressure, breaking strength and hydroxyproline content in group C and D pigs were significantly lower. No significant differences were observed in these parameters between groups A1, A2 and B. Abdominal adhesion was more severe in group D pigs. Collagen deposition in group A1, A2 and B pigs was dense in the anastomosis, and inflammatory cell infiltration was observed in group D.
  
  
  CONCLUSIONS
  IEPCHIP at 42.5 ± 0.5°C was safe and caused minimal impairments. However, anastomotic healing was affected by perfusion at 43.5 ± 0.5°C and 44.5 ± 0.5°C, and abdominal adhesion was most severe in the group D animals, which were perfused at 44.5 ± 0.5°C.
authors.forename: Sheng
authors.initials: S
authors.lastname: Li
authors.forename: Yong-lei
authors.initials: YL
authors.lastname: Zhang
authors.forename: Jia-yuan
authors.initials: JY
authors.lastname: Sun
authors.forename: Ya-wei
authors.initials: YW
authors.lastname: Hua
authors.forename: Pei-hong
authors.initials: PH
authors.lastname: Wu
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005743:Gastrectomy; D005763:Gastroenterostomy / Q000379:methods*; D006979:Hyperthermia, Induced; D007430:Intraoperative Care; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D010477:Perfusion; D010537:Peritoneum / Q000473:pathology*; D011182:Postoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D034421:Sus scrofa / Q000601:surgery; D013696:Temperature; D000267:Tissue Adhesions / Q000473:pathology / Q000601:surgery; D014945:Wound Healing
references.citation: BMC Cancer. 2005 Mar 31;5:31
references.pmid: 15801977
references.citation: J Clin Oncol. 2004 Aug 15;22(16):3284-92
references.pmid: 15310771
references.citation: Toxicol Mech Methods. 2011 Jun;21(5):393-9
references.pmid: 21426263
references.citation: Ann Surg Oncol. 2010 Sep;17(9):2370-7
references.pmid: 20336386
references.citation: Ann Surg Oncol. 2007 Dec;14(12):3443-52
references.pmid: 17909918
references.citation: Ann Surg Oncol. 2008 Nov;15(11):3299-307
references.pmid: 18712445
references.citation: Oncology. 1998 Mar-Apr;55(2):130-8
references.pmid: 9499187
references.citation: Cancer Treat Res. 1996;82:79-100
references.pmid: 8849945
references.citation: Surg Oncol. 2011 Mar;20(1):e38-54
references.pmid: 20888755
references.citation: Eur J Surg Oncol. 2006 Mar;32(2):186-90
references.pmid: 16303281
references.citation: Cancer Invest. 2012 Mar;30(3):209-24
references.pmid: 22360361
references.citation: Cancer. 2010 Dec 15;116(24):5608-18
references.pmid: 20737573
references.citation: Cancer. 2006 Mar 1;106(5):1144-53
references.pmid: 16456817
references.citation: World J Gastroenterol. 2008 Feb 28;14(8):1159-66
references.pmid: 18300340
references.citation: Ann Surg Oncol. 2007 Oct;14(10):2702-13
references.pmid: 17653801
references.citation: Ann Surg Oncol. 2012 Jul;19 Suppl 3:S475-82
references.pmid: 21837528
references.citation: Ann Surg. 2012 Feb;255(2):348-56
references.pmid: 22202584
references.citation: Ann Surg Oncol. 2013 Oct;20(11):3497-503
references.pmid: 23780382
references.citation: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references.pmid: 21296855
references.citation: Recent Results Cancer Res. 2007;169:11-23
references.pmid: 17506246
references.citation: J Surg Res. 2012 Apr;173(2):258-66
references.pmid: 21074782
references.citation: Nan Fang Yi Ke Da Xue Xue Bao. 2009 Feb;29(2):295-7
references.pmid: 19246304
references.citation: Ann Surg Oncol. 2010 Sep;17(9):2510-7
references.pmid: 20339948
references.citation: Acta Chir Belg. 2003 Jun;103(3):309-14
references.pmid: 12914369
references.citation: J Surg Oncol. 2008 Sep 15;98(4):247-52
references.pmid: 18726886
references.citation: Ann Surg Oncol. 2010 Jul;17(7):1957-63
references.pmid: 20143265
references.citation: Ann Surg. 2011 Jul;254(1):125-30
references.pmid: 21502859
references.citation: Bull Cancer. 2009 Oct;96(10):971-7
references.pmid: 19762323
references.citation: J Transl Med. 2011 May 07;9:53
references.pmid: 21548973
references.citation: J Surg Oncol. 2004 Feb;85(2):61-7
references.pmid: 14755505
references.citation: J Clin Oncol. 2010 Jan 1;28(1):5-7
references.pmid: 19917856
references.citation: Ann Surg Oncol. 2011 Jun;18(6):1575-81
references.pmid: 21431408
references.citation: Ann Surg Oncol. 2013 Jan;20(1):226-32
references.pmid: 22868919
references.citation: Ann Surg Oncol. 2007 Jan;14(1):128-33
references.pmid: 17072675
references.citation: PLoS One. 2008 Jun 18;3(6):e2428
references.pmid: 18560594
references.citation: Gynecol Oncol. 2009 May;113(2):228-32
references.pmid: 19254808
references.citation: Invest Ophthalmol Vis Sci. 1997 Nov;38(12):2516-22
references.pmid: 9375570
references.citation: Surgery. 1996 Apr;119(4):437-44
references.pmid: 8644010
references.citation: Cancer J. 2009 May-Jun;15(3):216-24
references.pmid: 19556908