Lack of significant intraoperative coagulopathy in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) indicates that epidural anaesthesia is a safe option

Figures & data

Table 1. Demographics of 51 patients undergoing cytoreductive surgery and HIPEC.

Characteristic	Frequency	Percentage (%)
Age‡ (range)	54.8 (23–77)
Gender
Female	32	62.7
Male	19	37.3
Diagnosis
Ovarian cancer	19	37.3
Colon cancer	8	15.7
Gastric cancer	7	13.7
Pancreatic cancer	6	11.8
Rectal cancer	5	9.8
Sarcoma	4	7.7
Uterine cancer	1	2.0
Primary peritoneal cancer	1	2.0
Degree of differentation
Low	6	11.8
High	45	88.2
Peritoneal cancer index‡ (range)	5.4 (3–30)
Cytoreduction score
CC-0	46	90.3
CC-1	2	3.9
CC-2	2	3.9
CC-3	1	1.9
PSS
PSS-0	39	76.5
PSS-1	2	3.9
PSS-2	6	11.8
PSS-3	4	7.8
ASA score
ASA 1	36	70.6
ASA 2	11	21.6
ASA 3	3	5.9
ASA 4	1	2
Karnofsky performance scale
90–100%	41	80.4
70–80%	8	15.7
50–60%	2	3.9

‡Mean values.

ASA, American Society of Anesthesiologists; PSS, Prior Surgical Score.

Figure 1. Fibrinogen levels were seen decreasing in different time points during cytoreductive surgery (A) as relevant D-Dimer levels were increasing (B).

Figure 2. Activated PTT levels at different time points during cytoreductive surgery and HIPEC.

Figure 3. INR levels are seen within normal limits at different time points during cytoreductive surgery and HIPEC.

Table 2. Changes in coagulation parameters studied before, during and after HIPEC‡.

Time point	Platelets (10^9/L)	Fibrinogen (mg/dL)	D-dimer (mg/dL)	PT	aPTT	INR
1	324.9 (128.1)	431.8 (220.3)	3.0 (2.2)	11.7 (1.1)	30.8 (5.8)	0.9 (0.1)
2	250.6 (105.4)	400.5 (209.1)	1.8 (1.0)	13.2 (1.3)	35.1 (4.6)	1.1 (0.2)
3	261.6 (134.6)	341.2 (148.1)	2.7 (1.7)	13.9 (1.6)	34.1 (7.6)	1.2 (0.3)
4	257.7 (111.1)	295.9 (127.4)	4.0 (2.1)	15.4 (2.3)	37.0 (14.7)	1.4 (0.4)
5	248.5 (100.9)	292.4 (151.7)	4.9 (3.3)	16.1 (2.4)	35.1 (16.7)	1.5 (0.5)
6	244.3 (99.6)	265 (104.0)	5.3 (3.1)	15.7 (2.8)	37.0 (13.2)	1.5 (0.4)

‡Values are expressed as mean (SD).

PT, prothrombin time (s); aPTT, activated partial thromboplastin time (s); INR, international normalised ratio.