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Journal of Oncology
Volume 2014, Article ID 307317, 6 pages
http://dx.doi.org/10.1155/2014/307317
Clinical Study

Intensive Care Unit Admission after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Is It Necessary?

1Department of Gastroenterology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14050 México City, DF, Mexico
2Department of Medical Oncology, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14080 México City, DF, Mexico
3Department of Embryology at the National Autonomous University of Mexico (UNAM), Insurgentes Sur s/n, Ciudad Universitaria, Colonia Copilco Universidad, 04360 México City, DF, Mexico
4Department of Critical Care Medicine, National Cancer Institute, San Fernando No. 22, Colonia Seccion XVI, 14080 México City, DF, Mexico

Received 20 November 2013; Revised 29 January 2014; Accepted 3 March 2014; Published 22 April 2014

Academic Editor: P. Neven

Copyright © 2014 Horacio N. López-Basave et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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/m2/L and mitomycin C 3.3 mg/m2/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.