The effect of intraoperative abdominal pressure on blood platinum levels and early complications during hyperthermic intraperitoneal chemotherapy.
During hyperthermic intraperitoneal chemotherapy (HIPEC), high intra-abdominal pressure (IAP) increases the penetration depth of chemotherapeutic agents. Cisplatin is one of the most commonly used chemotherapeutic agents during HIPEC, and nephrotoxicity is the most common adverse effect. In this study, we aimed to evaluate the relationship between IAP increase, cisplatin levels in the blood, and early complications.
During HIPEC, IAP was measured using a catheter placed in the intra-abdominal area. Those with IAP < 18 mmHg were classified into the low-pressure group, while those with IAP between 18 and 22 mmHg were classified into the high-pressure group. At the end of surgery, cisplatin levels were measured in the blood collected at 24 h and in urine collected during the first 24 h. Surgical data, postoperative blood levels, urine output, and 30-day morbidity and mortality outcomes were evaluated.
A total of 36 patients were included in the study: 17 in the low-pressure group and 19 in the high-pressure group. Although cisplatin levels in blood samples taken at 0 and 24 h postoperatively were higher in the high-pressure group, this difference was not statistically significant. There were no differences between the groups in terms of postoperative urea and creatinine levels or the incidence of postoperative complications.
Our study demonstrated that different IAP during HIPEC do not affect the systemic circulation of cisplatin or short-term systemic complications.
During HIPEC, IAP was measured using a catheter placed in the intra-abdominal area. Those with IAP < 18 mmHg were classified into the low-pressure group, while those with IAP between 18 and 22 mmHg were classified into the high-pressure group. At the end of surgery, cisplatin levels were measured in the blood collected at 24 h and in urine collected during the first 24 h. Surgical data, postoperative blood levels, urine output, and 30-day morbidity and mortality outcomes were evaluated.
A total of 36 patients were included in the study: 17 in the low-pressure group and 19 in the high-pressure group. Although cisplatin levels in blood samples taken at 0 and 24 h postoperatively were higher in the high-pressure group, this difference was not statistically significant. There were no differences between the groups in terms of postoperative urea and creatinine levels or the incidence of postoperative complications.
Our study demonstrated that different IAP during HIPEC do not affect the systemic circulation of cisplatin or short-term systemic complications.
Authors
Kulturoglu Kulturoglu, Aydin Aydin, Aslan Aslan, Sagdic Sagdic, Tunc Tunc, Aksel Aksel, Dogan Dogan
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