title: Usefulness of thermographic analysis to control temperature homogeneity in the development and implementation of a closed recirculating CO2chemohyperthermia model.
abstract: OBJECTIVE
  To determine the effectiveness of thermography to control the distribution of abdominal temperature in the development of a closed chemohyperthermia model.
  
  
  METHODS
  For thermographic analysis, we divided the abdominopelvic cavity into nine regions according to a modification of carcinomatosis peritoneal index. A difference of 2.5 °C between and within the quadrants, and thermographic colours, were used as asymmetric criteria. Preclinical study:· Rats Model: Six athymic nude rats, male, rnu/rnu. They were treated with closed technique and open technique. Porcine Model: 12 female large white pigs. Four were treated with open technique and eight with closed recirculation CO2technique. Clinical Pilot Study, EUDRACT 2011-006319-69: 18 patients with ovarian cancer were treated with cytoreductive surgery and hyperthermia intraperitoneal chemotherapy, HIPEC, with a closed recirculating CO2system. Thermographic control and intra-abdominal temperature assessment was performed at the baseline, when outflow temperature reached 41 °C, and at 30´.
  
  
  RESULTS
  The thermographic images showed a higher homogeneity of the intra-abdominal temperature in the closed model respect to the open technique. The thermogram showed a temperature distribution homogeneity when starting the circulation of chemotherapy. There was correlation between the temperature thermographic map in the closed porcine model and pilot study, and reached inflow and outflow temperatures, at half time of HIPEC, of 42/41.4 °C and 42 ± 0.2/41 ± 0.8 °C, respectively. There was no significant impact to the core temperature of patients after reaching the homogeneous temperature distribution.
  
  
  CONCLUSIONS
  To control homogeneity of temperature distribution is feasible using infra-red digital images in a closed HIPEC with CO2recirculation.
authors.affiliation: a Department of Surgery , Faculty of Medicine, University General Hospital , Ciudad Real , Spain.
authors.forename: David
authors.initials: D
authors.lastname: Padilla-Valverde
authors.affiliation: a Department of Surgery , Faculty of Medicine, University General Hospital , Ciudad Real , Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Sanchez-Garcia
authors.affiliation: a Department of Surgery , Faculty of Medicine, University General Hospital , Ciudad Real , Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: García-Santos
authors.affiliation: b Department of Interne Medicine, Marques de Valdecilla , University General Hospital , Santander , Cantabria , Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Marcote-Ibañez
authors.affiliation: c Department of Interne Medicine , Santa Barbara Hospital , Puertollano, Ciudad Real , Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Molina-Robles
authors.affiliation: a Department of Surgery , Faculty of Medicine, University General Hospital , Ciudad Real , Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Martín-Fernández
authors.affiliation: a Department of Surgery , Faculty of Medicine, University General Hospital , Ciudad Real , Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Villarejo-Campos
keywords:  HIPEC; Infra-red images; Thermography; closed HIPEC