title: Are there intra-operative hemodynamic differences between the Coliseum and closed HIPEC techniques in the treatment of peritoneal metastasis? A retrospective cohort study.
abstract: BACKGROUND
  Although two main methods of intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) are currently accepted, the superiority of one over the other has not yet been demonstrated. The purpose of this study was to determine whether there are hemodynamic and temperature differences between patients who received HIPEC in two different techniques, open versus closed abdomen.
  
  
  METHODS
  This retrospective study was conducted in our center between 2011-2015 in 30 patients who underwent surgery for peritoneal carcinomatosis secondary to colorectal cancer, in whom cytoreduction and HIPEC were performed by the Coliseum (15) or closed techniques (15). The main end points were morbidity, mortality, hemodynamic changes, and abdominal temperature. The comparative analysis of quantitative variables at different times was done with the parametric repeated measure ANOVA for those variables that fulfilled the suppositions of normality and independence and the Friedman non-parametric test for the variables that did not fulfill either of these suppositions.
  
  
  RESULTS
  There were no deaths in either group. The incidence of postoperative complications in the Coliseum group was 53% (8 patients), grade II-III. The incidence of complications in the closed group was 13% (2 patients), grade II-III. The intra-operative conditions regarding the systolic and diastolic pressures were more stable using the closed abdomen technique (but not significantly so). We found statistically significant differences in abdominal temperature in favor of the closed technique (p = 0.009).
  
  
  CONCLUSIONS
  Both HIPEC procedures are similar. In our series, the closed technique resulted in a more stable intra-abdominal temperature.
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain. cristinars86@gmail.com.
authors.forename: Cristina
authors.identifier: http://orcid.org/0000-0002-1084-2223
authors.initials: C
authors.lastname: Rodríguez Silva
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Moreno Ruiz
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Bellido Estévez
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Carrasco Campos
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Titos García
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruiz López
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Ivan
authors.initials: I
authors.lastname: González Poveda
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Toval Mata
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Mera Velasco
authors.affiliation: Universidad de Málaga, Departamento de Farmacología, Servicio de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Avda Carlos Haya, 29020, Malaga, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Santoyo Santoyo
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000628:therapy*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies
keywords: Closed technique; Coliseum technique; HIPEC; Peritoneal carcinomatosis; Peritoneal metastasis