Pulmonary influences on early post-operative recovery in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: a retrospective study

Background: The combination of cytoreductive surgery (CRS) and hyperthermic intraperitonealchemotherapy (HIPEC) is a curative treatment option for peritoneal carcinomatosis (PC).There have been few studies on the pulmonary adverse events (AEs) affecting patientrecovery after this treatment, thus this study investigated these factors. Methods: Between January 2005 and December 2006, clinical data on all pulmonary AEs and therecovery progress were reviewed for 76 patients with after CRS and HIPEC. Patients withpulmonary interventions (thoracocenthesis and chest tubes) were compared with the noninterventionpatients. Two senior radiologists, blinded to the post-operative clinical course,separately graded the occurrence of pulmonary AEs. Results: Of the 76 patients, 6 had needed thoracocentesis and another 6 needed chest tubes. Therewere no differences in post-operative recovery between the intervention and non-interventiongroups. The total number of days on mechanical ventilation, the length of stay in theintensive care unit, total length of hospital stay, tumor burden, and an American Society ofAnesthesiologists (ASA) grade of greater than 2 were correlated with the occurrence ofatelectasis and pleural effusion. Extensive atelectasis (grade 3 or higher) was seen in sixpatients, major pleural effusion (grade 3) in seven patients, and signs of heart failure (grade1-2) in nine patients. Conclusions: Clinical and radiological post-operative pulmonary AEs are common after CRS and HIPEC.However, most of the pulmonary AEs did not affect post-operative recovery.

via World Journal of Surgical Oncology