Perfusion for hyperthermic intraperitoneal chemotherapy by cardiopulmonary bypass machine
Cardiopulmonary Bypass: Advances in Extracorporeal Life Support, Elsevier, ss.515-526, 2022
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2022
- Doi Numarası: 10.1016/b978-0-443-18918-0.00032-2
- Yayınevi: Elsevier
- Sayfa Sayıları: ss.515-526
- Anahtar Kelimeler: Carcinomatosis, CPB, cytoreductive surgery, heat-changer, HIPEC, hyperthermic intraperitoneal chemotherapy, peritoneal metastasis, peritoneum
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Peritoneal carcinomatosis is malignancy of the peritoneum with a low incidence caused primary by peritoneum itself or secondary due to spread from the other organs, especially from ovarian, gastrointestinal systems including colorectal, appendical, and gastric malignancies. It is resistant to conventional chemotherapy and has a poor prognosis. Stages of the peritoneal metastatic cascade include dissociation from primary tumor, spreading to peritoneum, invasion of subperitoneal area, proliferation, and angiogenesis. To improve treatment outcomes, survival, and quality of life, various therapies have been developed and combination of the cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is the most popular approach due to its potentially curative and aggressive nature. Cancer should be isolated to the peritoneal cavity, a form of locoregional disease, to benefit from the effective CRS–HIPEC. The aim of CRS is to remove the peritoneum and organs if necessary, until no visible tumor remains. Elimination of the microscopic tumor foci in the peritoneal space is aimed by applying HIPEC using a warmed solution (41°C–43°C) after the surgical removal of macroscopic tumor and tumor foci. With the administration of chemotherapeutic drugs to the intraperitoneal cavity instead of systemic administration, regional high concentration levels are reached and a stronger drug effect can be achieved with less systemic side effects.