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Open Access Research

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

Erebouni Arakelian1*, Michael R Torkzad2, Antonina Bergman2, Sten Rubertsson3 and Haile Mahteme1

Author Affiliations

1 Department of Surgical Sciences, Section of Surgery, Uppsala University, Uppsala, Sweden

2 Department of Radiology, Oncology and Radiation Science, Section of Radiology, Uppsala University, Uppsala, Sweden

3 Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden

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World Journal of Surgical Oncology 2012, 10:258  doi:10.1186/1477-7819-10-258

Published: 27 November 2012

Abstract

Background

The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a curative treatment option for peritoneal carcinomatosis (PC). There have been few studies on the pulmonary adverse events (AEs) affecting patient recovery after this treatment, thus this study investigated these factors.

Methods

Between January 2005 and December 2006, clinical data on all pulmonary AEs and the recovery progress were reviewed for 76 patients with after CRS and HIPEC. Patients with pulmonary interventions (thoracocenthesis and chest tubes) were compared with the non-intervention patients. 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. There were no differences in post-operative recovery between the intervention and non-intervention groups. The total number of days on mechanical ventilation, the length of stay in the intensive care unit, total length of hospital stay, tumor burden, and an American Society of Anesthesiologists (ASA) grade of greater than 2 were correlated with the occurrence of atelectasis and pleural effusion. Extensive atelectasis (grade 3 or higher) was seen in six patients, major pleural effusion (grade 3) in seven patients, and signs of heart failure (grade 1–2) 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.

Keywords:
Peritoneal carcinomatosis; CRS; HIPEC; Post-operative recovery; Pulmonary influences; Radiological assessment