Wajekar AS, Solanki SL, Patil VP. Postoperative complications and critical care management after cytoreduction surgery and hyperthermic intraperitoneal chemotherapy: A systematic review of the literature. World J Crit Care Med 2022; 11(6): 375-386 [PMID: 36439322 DOI: 10.5492/wjccm.v11.i6.375]
Corresponding Author of This Article
Sohan Lal Solanki, MD, Professor, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, 2nd Floor, Main Building, Tata Memorial Hospital, Dr E Borges Marg, Parel, Mumbai 400012, Maharashtra, India. me_sohans@yahoo.co.in
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Nov 9, 2022; 11(6): 375-386 Published online Nov 9, 2022. doi: 10.5492/wjccm.v11.i6.375
Postoperative complications and critical care management after cytoreduction surgery and hyperthermic intraperitoneal chemotherapy: A systematic review of the literature
Anjana S Wajekar, Sohan Lal Solanki, Vijaya P Patil
Anjana S Wajekar, Sohan Lal Solanki, Vijaya P Patil, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai 400012, Maharashtra, India
Author contributions: Wajekar AS and Solanki SL helped in the literature review and writing of the manuscript; Wajekar AS, Solanki SL and Patil VP helped in editing the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sohan Lal Solanki, MD, Professor, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, 2nd Floor, Main Building, Tata Memorial Hospital, Dr E Borges Marg, Parel, Mumbai 400012, Maharashtra, India. me_sohans@yahoo.co.in
Received: March 13, 2022 Peer-review started: March 13, 2022 First decision: May 31, 2022 Revised: June 13, 2022 Accepted: September 9, 2022 Article in press: September 9, 2022 Published online: November 9, 2022 Processing time: 235 Days and 15.9 Hours
Abstract
BACKGROUND
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a comprehensive treatment option performed for peritoneal surface malignancies. Postoperatively almost all patients are transferred to the intensive care unit electively.
AIM
To describe the common and rare postoperative complications, postoperative mortality and their critical care management after CRS-HIPEC.
METHODS
The authors assessed 54 articles for eligibility. Full text assessment identified 14 original articles regarding postoperative complications and critical care management for inclusion into the final review article.
RESULTS
There is an exaggerated metabolic and inflammatory response after surgery which may be termed as physiological in view of the nature of surgery combined with the use of heated intraperitoneal chemotherapy with/out early postoperative intravenous chemotherapy. The expected postoperative course is further discussed. CRS-HIPEC is a complex procedure with some life-threatening complications in the immediate postoperative period, reported morbidity rates between 12%-60% and a mortality rate of 0.9%-5.8%. Over the years, since its inception in the 1980s, postoperative morbidity and survival have significantly improved. The commonest postoperative surgical complications and systemic toxicity due to chemotherapy as reported in the last decade are discussed.
CONCLUSION
CRS-HIPEC is associated with a varying rate of postoperative complications including postoperative deaths and needs early suspicion and intensive care monitoring.
Core Tip: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a complex procedure with some life-threatening complications in the immediate postoperative period, reported morbidity rates between 12%-60% and a mortality rate of 0.9%-5.8%. There is an exaggerated metabolic and inflammatory response after surgery which may be termed as physiological in view of the nature of surgery combined with use of heated intraperitoneal chemotherapy.
