Management in extracorporeal circulation of hyperthermic isolated perfusion chemotherapy in the treatment of pelvic cancer (case report)

Li Quan-zheng; Wang Xue-yan

doi:10.13498/j.cnki.chin.j.ecc.2015.04.12

Abstract：Objective To summarize the experience with the management of pelvic cavity isolated perfusion chemotherapy (PIPC) by extracorporeal circulation(ECC). Methods Recently 1 case of advanced cervical squamous cell carcinoma underwent ECC assisted hyperthermic PIPC by balloon catheter occlusion both in abdominal aorta and inferior vena cava, and by bilateral thigh tourniquet to block lower extremity blood flow before ECC. After femoral artery and vein intubation and connecting the closed and open type dual-purpose ECC system to the isolatied pelvic cavity mentioned above, ECC assisted hyperthermic PIPC began. During PIPC chemotherapy drugs were injected into the ECC system. Continuous blood heating was achieved by water from heater-cooler. Chemo?therapy drugs was cleared by ultrafiltration before removal of the pelvic cavity isolation. Results Intubation of balloon catheter and femoral artery and vein cannulaswas smooth. ECC pipeline system maintained closed. The total ECC time was 90min. ECC flow was 12. 8 to 22.2 ml/ ( kg·min) . Bladder temperature reached 39.0 degrees andisolation time for regional pelvic below pelvis( including pel?vis) was 90min whilst pelvic isolation time was 70min and lower limb blood flow occlusion time was 70 min. The ultrafiltration time was 40min, ultrafiltration volume was 3250 ml, including zero balanced ultrafiltration volume of 2500 ml and conventional ultrafiltration of 750 ml. Patient was extubated in the operating room, with postoperative recovery smoothly, with no injury of liver and kidney or other chemotherapy related complications. The patient was discharged 7 days after operation. The 14-days postoperative ultrasonography showed that the pelvic floor tumor significantly shrinked. Conclusion Results from this case of ECC assisted hyperthermic PIPC in the treatment of pelvic cancer showed that this therapeutic schedule is feasible and effective to inhibit tumor progression. Different from con?ventional ECC, The technique, equipment and ECC management are very important and specialized.