Cytoreduction with Hyperthermic Intraperitoneal Chemotherapy and Renal Insufficiency Related to Diabetes Mellitus: An Anesthetic Challenge

Adrian Bartos¹, Caius Breazu^2,3, Dana Bartos^2,3, Lidia Ciobanu^3,4, Calin Mitre^2,3

1 Department of Surgery, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. Octavian Fodor”, Cluj-Napoca, Romania
2 Department of Anesthesiology and Intensive Care Medicine, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. Octavian Fodor”, Cluj-Napoca, Romania
3 University of Medicine and Pharmacy „Iuliu Hatieganu”, Cluj-Napoca, Romania
4 Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology, “Prof. Dr. Octavian Fodor”, Cluj-Napoca, Romania

DOI: 10.1515/jccm-2017-0027

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves the prognosis in selected patients with peritoneal surface malignancies but it is an extensive procedure predisposing to major complications. Among them, renal toxicity was reported. Severe renal insufficiency is considered a contraindication for this complex procedure. We present a patient with diabetic nephropathy with renal insufficiency KDOQI 3 and peritoneal metastasis from sigmoid adenocarcinoma with a good clinical outcome after CRS with HIPEC, highlighting the anesthetic precautions considered for this particular clinical case.