Perioperative management of surgery debulking with chemotherapy hyperthermic intraperitoneal

Abstract

Peritoneal carcinomatosis is defined as tumor dissemination within the abdominal cavity secondary to the growth of tumors on the peritoneal surface or visceral organs. This condition, regardless of the origin of the primary tumor, is usually associated with the progression of the underlying oncological disease and carries a worse short-term prognosis. In recent years, the better understanding of the pathways of tumor spread associated with the protective function of the peritoneal barrier against cancer spread has led to peritoneal carcinomatosis being considered a locoregional disease. Consequently, new therapeutic strategies have emerged that combine cytoreduction surgery with hyperthermic intraperitoneal chemotherapy in patients suffering from peritoneal carcinomatosis secondary to tumors of appendicular, gastrointestinal, gynecological origin and peritoneal mesothelioma, with promising results in terms of prolonged survival. .
The objective of this monograph is to make a bibliographic review of the perioperative management of patients who undergo debulking surgery associated with hyperthermic intraperitoneal chemotherapy and to explain the physiological foundations with the possible complications of this procedure associated with hemodynamic, respiratory and metabolic changes.