Pleural spread occurs in pseudomyxoma peritonei (PMP) in less than 10% of the patients and is treated by thoracic cytoreductive surgery with or without hyperthermic intrathoracic chemotherapy (HITOC). It is performed both for symptom palliation and disease control and includes pleurectomy and decortication and wedge and segmental lung resections. So far, only unilateral spread treated with a thoracic cytoreductive surgery (CRS) has been reported in literature.
View Article and Find Full Text PDFIndian J Anaesth
December 2019
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for primary peritoneal malignancies or peritoneal spread of malignant neoplasm is being done at many centres worldwide. Perioperative management is challenging with varied haemodynamic and temperature instabilities, and the literature is scarce in many aspects of its perioperative management. There is a need to have coalition of the existing evidence and experts' consensus opinion for better perioperative management.
View Article and Find Full Text PDFCoagulopathy either from the use of anticoagulant, antiplatelet, or thrombolytic medications or from underlying medical conditions is considered one of the major risk factors for epidural hematoma formation related to epidural catheter placement or removal. The American Society of Regional Anesthesia and Pain Medicine (ASRA) has laid down guidelines regarding timing of neuraxial blockade or removal of neuraxial catheters in patients receiving either antithrombotic or thrombolytic therapy. We present a case of acute onset of paraplegia because of an epidural hematoma following removal of the epidural catheter in a patient who was given the first dose of antithrombotic therapy after the removal of the epidural catheter as per the ASRA guidelines.
View Article and Find Full Text PDFPurpose: To evaluate the short-term outcomes of patients of pseudomyxoma peritonei (PMP) of appendiceal origin treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) at two tertiary Indian centers.
Methods: Data was prospectively collected from January 2011 to January 2016. Palliative procedures were excluded.
Background: Large-volume lipoplasty is becoming more common and has been proven to be safe and effective. Large-volume lipoplasty is normally performed with the patient under general anesthesia. Techniques of general anesthesia and fluid management are important factors in improving the safety of large-volume lipoplasty.
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