Back to Search Start Over

Current Delivery of Hyperthermic Intraperitoneal Chemotherapy with Cytoreductive Surgery (CS/HIPEC) and Perioperative Practices: An International Survey of High-Volume Surgeons

Authors :
Allison H. Maciver
Joseph J. Skitzki
Valerie Francescutti
Eisar Al-Sukhni
John M. Kane
Jesus Esquivel
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.

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