Yu-Jie Yuan, Wu Song, Jian-Bo Xu, Chuan-Qi Chen, Fang-Hai Han, Shi-Rong Cai, Yu-Long He
Objective: The peritoneal carcinomatosis commonly occurs in end stage of various digestive malignances. Combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been widely accepted as effective palliative treatments for patients in end stage malignances. This study was designed to investigate whether a stable perfusion temperature could enhance bowel recovery after palliative surgery.
Methods: A consecutive series of 59 patients underwent CRS and HIPEC between January 2012 and July 2013 were retrospectively reviewed. All patients were artificially divided into two groups according to the stability of perfusion temperature: study group with stable perfusion temperature and control group with unstable temperature. After three cycles of HIPEC treatments, flatus time, enteral nutrition initiation time, defecation recovery time and postoperative pain (VAS score) were utilized to compare bowel function recovery between the two groups.
Results: In all, 33 of 59 (55.9%) patients underwent relatively stable hyperthermic perfusion treatments. Compared with those who had unstable perfusion temperature, the average flatus time (2.3±1.2 vs. 3.9±2.2 days, P=0.002) and time of enteral nutrition initiation (4.3±1.5 vs. 6.7±2.3 days, P<0.001) were significantly decreased in the study group, as well as the defecation recovery time (5.2±2.1 vs. 7.1±2.9 days, P=0.004). Besides, the average VAS score was markedly decreased (4.5±2.3 vs. 6.3±1.3, P<0.001).
Conclusions: A stable perfusion temperature during the HIPEC therapy can promote bowel function recovery, reduce postoperative pain, and benefit the initiation of subsequent enteral nutrition therapy.
