title: Intensive care unit admission after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Is it necessary?
abstract: Introduction. Cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a new approach for peritoneal carcinomatosis. However, high rates of complications are associated with CS and HIPEC due to treatment complexity; that is why some patients need stabilization and surveillance for complications in the intensive care unit. Objective. This study analyzed that ICU stay is necessary after HIPEC. Methods. 39 patients with peritoneal carcinomatosis were treated according to strict selection criteria with CS and HIPEC, with closed technique, and the chemotherapy administered were cisplatin 25 mg/m(2)/L and mitomycin C 3.3 mg/m(2)/L for 90-minutes at 40.5°C. Results. 26 (67%) of the 39 patients were transferred to the ICU. Major postoperative complications were seen in 14/26 patients (53%). The mean time on surgical procedures was 7.06 hours (range 5-9 hours). The mean blood loss was 939 ml (range 100-3700 ml). The mean time stay in the ICU was 2.7 days. Conclusion. CS with HIPEC for the treatment of PC results in low mortality and high morbidity. Therefore, ICU stay directly following HIPEC should not be standardized, but should preferably be based on the extent or resections performed and individual patient characteristics and risk factors. Late complications were comparable to those reported after large abdominal surgery without HIPEC.
authors.affiliation: Department of Gastroenterology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14050 México City, DF, Mexico.
authors.forename: Horacio N
authors.initials: HN
authors.lastname: López-Basave
authors.affiliation: Department of Medical Oncology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14080 México City, DF, Mexico.
authors.forename: Flavia
authors.initials: F
authors.lastname: Morales-Vasquez
authors.affiliation: Department of Embryology at the National Autonomous University of Mexico (UNAM), Insurgentes Sur s/n, Ciudad Universitaria, Colonia Copilco Universidad, 04360 México City, DF, Mexico.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mendez-Herrera
authors.affiliation: Department of Critical Care Medicine, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14080 México City, DF, Mexico.
authors.forename: Silvio A
authors.initials: SA
authors.lastname: Namendys-Silva
authors.affiliation: Department of Gastroenterology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14050 México City, DF, Mexico.
authors.forename: Kuauhyama
authors.initials: K
authors.lastname: Luna-Ortiz
authors.affiliation: Department of Medical Oncology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14080 México City, DF, Mexico.
authors.forename: German
authors.initials: G
authors.lastname: Calderillo-Ruiz
authors.affiliation: Department of Critical Care Medicine, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14080 México City, DF, Mexico.
authors.forename: Jesús
authors.initials: J
authors.lastname: Cabrera Rojas
authors.affiliation: Department of Medical Oncology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14080 México City, DF, Mexico.
authors.forename: Erika
authors.initials: E
authors.lastname: Ruiz-Garcia
authors.affiliation: Department of Gastroenterology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14050 México City, DF, Mexico.
authors.forename: Angel
authors.initials: A
authors.lastname: Herrera-Gomez
authors.affiliation: Department of Gastroenterology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14050 México City, DF, Mexico.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Ruiz-Molina
authors.affiliation: Department of Embryology at the National Autonomous University of Mexico (UNAM), Insurgentes Sur s/n, Ciudad Universitaria, Colonia Copilco Universidad, 04360 México City, DF, Mexico.
authors.forename: Abelardo
authors.initials: A
authors.lastname: Meneses Garcia