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Current Delivery of Hyperthermic Intraperitoneal Chemotherapy with Cytoreductive Surgery (CS/HIPEC) and Perioperative Practices: An International Survey of High-Volume Surgeons
- Source :
- Annals of Surgical Oncology. 24:923-930
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Cytoreductive surgery and heated intraperitoneal chemotherapy (CS/HIPEC) is performed for selected indications at a limited number of specialized centers worldwide. Currently there is no standardized approach to the perioperative care process. We sought to capture current practices in the perioperative management of patients who undergo CS/HIPEC at high-volume centers.Surgeon members of the American Society of Peritoneal Surface Malignancies working at high-volume CS/HIPEC centers (10 cases/year) were invited to complete an online survey. The survey included questions relating to preoperative preparation of patients, intraoperative practices, and postoperative care.Ninety-seven surgeons from five continents completed the survey (response rate 55%). The majority (80%) practiced in academic environments. Most respondents (68%) indicated that a formal preoperative preparatory pathway for CS/HIPEC surgery existed at their centers, but few (26%) had used enhanced recovery protocols in this group of patients. Whereas the intraoperative technical practices of the CS/HIPEC procedure were relatively consistent across respondents, there was little agreement on pre- and postoperative care practices, including use of mechanical bowel preparation, nutritional supplementation, methods of perioperative analgesia, timing of physical therapy and ambulation, nasogastric tube and Foley removal, intravenous fluids, blood transfusion parameters, and postoperative use of deep-vein thrombosis prophylaxis and antibiotics.Perioperative care practices for CS/HIPEC are widely variable nationally and internationally. Standardization of such practices offers an opportunity to incorporate evidence-based interventions and may enhance patient outcomes and improve care standards across all centers that offer this procedure.
- Subjects :
- Adult
medicine.medical_specialty
Perioperative Care
03 medical and health sciences
0302 clinical medicine
Cytoreduction Surgical Procedures
Monitoring, Intraoperative
Surveys and Questionnaires
Antineoplastic Combined Chemotherapy Protocols
Preoperative Care
Humans
Medicine
Anesthesia
Blood Transfusion
Infusions, Parenteral
Practice Patterns, Physicians'
Antibiotic prophylaxis
Early Ambulation
Peritoneal Neoplasms
Physical Therapy Modalities
Aged
Postoperative Care
Venous Thrombosis
Intraoperative Care
Perioperative management
Nutritional Support
business.industry
General surgery
International survey
Hyperthermia, Induced
Perioperative
Antibiotic Prophylaxis
Middle Aged
Surgery
Oncology
030220 oncology & carcinogenesis
Perioperative care
Fluid Therapy
030211 gastroenterology & hepatology
Hyperthermic intraperitoneal chemotherapy
Analgesia
business
Cytoreductive surgery
Hospitals, High-Volume
Subjects
Details
- ISSN :
- 15344681 and 10689265
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....48b6d4e1bd5e951db80e52e7fcbae612
- Full Text :
- https://doi.org/10.1245/s10434-016-5692-3