Some features of intraoperative infusion-transfusion therapy when performing cytoreductive operations with the use of hyperthermic intraperitoneal chemotherapy in patients with ovarian cancer: retrospective cohort study

Abstract

Introduction. Сytoreductive operations with using hyperthermic intraoperative intraperitoneal chemotherapy(CR + HIPEC) is an effective technology in the treatment of locally advanced and metastatic ovarian cancer, the relevance of the treatment of this one’s is beyond doubt. The neсessity of protection organs and systems of the body from a stress response, correction of water and electrolyte balance, blood loss, volemia, and prevention of the toxic effects of chemotherapy make infusion-transfusion therapy (ITT) one of the main components of anesthesia during such operations. Objectives. An analyze the qualitative and quantitative composition of perioperative infusion-transfusion therapy in patients with advanced stages of ovarian cancer during cytoreductive operation with the addition of HIPEC of the abdominal cavity. Materials and methods. In retrospective study 84 patients, 2 types of surgical interventions and anesthetic accompaniment were analyzed, depending on the availability of HIPEC. The duration of the anesthetic treatment, the doses of the anesthetics, the volume of blood loss, the volume and quality of intraoperative infusion therapy were assessed. Results. With ITT carried out with cytoreduction using GIIH, the volume of administration of crystalloid solutions increases by 2.3 times; the average value of the infusion volume increases by 16 (10,5–20) ml/kg/hour. When analyzing the proportional ratio of crystalloid and colloidal solutions, their qualitative composition with CR + GIIH consists of: erythrocyte suspension 3.1 %, FFP 13.6 %, colloidal solutions 8.52 %, crystalloid solutions 74.6 % of total infusion’s volume. Conclusions. Perioperative ITT performed with cytoreduction using GIIH differs significantly from ITT without that. The necessity for high-volume infusion-transfusion therapy by increasing the introduction of crystalloids during cytoreductive operations with hyperthermic intraoperative intraperitoneal chemotherapy was revealed. This technique had no complications and allowed maintaining the stability of hemodynamics, volumetric volume and the required volume of diuresis. The use of a “balanced electrolyte solution” is preferable for intraoperative high-volume ITT.