Hipertermik İntraperitoneal Kemoterapi Yapılan Hastalarda İntraoperatif Restriktif Sıvı Tedavisinin Postoperatif Sonuçlar Üzerine Etkisi

Amaç: Hipertermik intraperitoneal kemoterapi (HİPEK) ve sitoredüktif cerrahi (SRC) peritoneal karsinomatozisli olgularda etkili multimodal tedavi seçeneklerindendir. Bu girişimler, kan ve sıvı kaybının fazla olduğu, uzun süren ameliyatlardır. Major hemodinamik, respiratuvar ve metabolik değişiklikler nedeniyle intraoperatif sıvı yönetimi oldukça önemlidir. Bu çalışma, HİPEK ve SRC yapılan hastalarda, intraoperatif restriktif sıvı tedavisinin postoperatif derlenme üzerine etkisini araştırmayı amaçlamıştır. Yöntem: Kliniğimizde 2014-2018 yılları arasında HİPEK ve SRC yapılan hastalar çalışmaya dâhil edildi. Retrospektif olarak tüm hastaların demografik, intraoperatif ve postoperatif verileri incelendi, restriktif sıvı replasmanı yapılan hastalara Grup R, liberal sıvı replasmanı yapılan gruba ise Grup L adı verildi. Bulgular: Hastaların yaş ortalamasının 54.6±11.4 yıl, kadın cinsiyetin %60.5 ve gastrointestinal sistem kaynaklı malignensinin de %76.3 olduğu gözlendi. Liberal ve restriktif sıvı tedavilerinin postoperatif minör ve major komplikasyonlarda, hastanede ve yoğun bakım kalış sürelerinde ve mortalite üzerine etkisi bulunmadı. Sonuç: HİPEK ve SRC ameliyatlarında intraoperatif restriktif sıvı tedavisinin postoperatif komplikasyonlar ve mortaliteyi etkilemediği sonucuna vardık.

The Effect of Intraoperative Restrictive Fluid Therapy on Postoperative Outcomes in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy

Objective: Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRC) are effective multimodal treatment options in patients with peritoneal carcinomatosis. Procedures are long-lasting operations with excessive blood and fluid loss. Intraoperative fluid management is very important because of major hemodynamic, respiratory and metabolic changes. This study aims to investigate the effect of intraoperative restrictive fluid therapy on postoperative outcome in patients undergoing HIPEC and SRS. METHODS: Patients who underwent HIPEC and SRS in our clinic between 2014-2018 were included in the study. The demographic, intraoperative and postoperative data of all patients were retrospectively analyzed. The patients who underwent restrictive fluid replacement were named Group R, and the group with liberal fluid replacement was named Group L. RESULTS: It was observed that the mean age was 54.6±11.4 years, the female gender was 60.5% and the malignancy originating from the gastrointestinal system was 76.3%. There was no effect of liberal and restrictive fluid treatments on postoperative minor and major complications, length of stay in hospital and intensive care, and mortality. Conclusion: We concluded that intraoperative restrictive fluid therapy did not affect postoperative complications and mortality in HIPEC and SRS surgeries.

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