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https://www.readbyqxmd.com/read/29643552/anaesthetic-management-and-perioperative-outcomes-of-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy-a-retrospective-analysis
#1
Kalpana P Balakrishnan, Sreedevi Survesan
Background and Aims: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is becoming the standard treatment option for peritoneal carcinomatosis but is associated with high rates of morbidity and mortality. Our aim was to retrospectively analyse and evaluate intra-operative factors associated with morbidity and mortality of CRS and HIPEC. Methods: Intra-operative data were collected for cases done over 1 year (24 cases) and analysed for the primary outcome of post-operative ventilation >24 h, and secondary outcome of length of the Intensive Care Unit (ICU) stay >5 days...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29581681/robot-assisted-mckeown-esophagectomy-is-feasible-after-neoadjuvant-chemoradiation-our-initial-experience
#2
Ashish Goel, Swati H Shah, Veda Padma Priya Selvakumar, Shubha Garg, Kapil Kumar
Neoadjuvant chemoradiation has become the standard of care for esophageal cancer, especially for middle third esophageal lesions and those with squamous histology. Although more and more thoracic surgeons and surgical oncologists have now shifted to video-assisted and robot-assisted thoracoscopic esophagectomy; there is still limited experience for the use of minimal-assisted approaches in patients undergoing surgery after neoadjuvant chemoradiation. Most surgeons have concerns of feasibility, safety, and oncological outcomes as well as issues related to difficult learning curve in adopting robotic esophagectomy in patients after chemoradiation...
February 2018: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29579262/acute-kidney-injury-in-critically-ill-patients-with-solid-tumours
#3
Delphine Kemlin, Lucie Biard, Lionel Kerhuel, Lara Zafrani, Marion Venot, Luis Teixeira, Benoit Schlemmer, Elie Azoulay, Emmanuel Canet
Background: Patients with solid tumours are at risk for acute kidney injury (AKI), however, epidemiological data are limited. Methods: We conducted a study that included patients with solid tumours admitted to a single-centre intensive care unit (ICU) from January 2011 to December 2015. We analysed factors associated with the occurence of AKI, ICU and Day-90 mortality. Results: Two-hundred and four patients were included. The incidence of AKI was 59%, chiefly related to sepsis (80%), hypovolaemia (40%) and outflow tract obstruction (17%)...
March 22, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29569126/palliative-care-is-associated-with-reduced-aggressive-end-of-life-care-in-patients-with-gastrointestinal-cancer
#4
Shaila J Merchant, Susan B Brogly, Craig Goldie, Christopher M Booth, Sulaiman Nanji, Sunil V Patel, Katherine Lajkosz, Nancy N Baxter
BACKGROUND: We examined the delivery of physician palliative care (PC) services and its association with aggressive end-of-life care (EOLC) in patients with gastrointestinal (GI) cancer in Ontario, Canada. METHODS: All patients with primary cause of death from esophageal, gastric, colon, and anorectal cancer from January 2003 to December 2013 were identified. PC services within 2 years of death were classified: (1) any PC; (2) timing of first PC (≤ 7, 8-90, 91-180, and 181-730 days before death); and (3) intensity of PC measured by number of days used (1st-25th, 26th-50th, 51st-75th, and 76th-100th percentiles)...
March 22, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29507790/hyperthermic-intrathoracic-chemotherapy-after-extended-pleurectomy-and-decortication-for-malignant-pleura-mesothelioma-an-observational-study-on-outcome-and-microcirculatory-changes
#5
Luca Luzzi, Federico Franchi, Annarita Dapoto, Marco Ghisalberti, Roberto Corzani, Daniele Marrelli, Luca Marchetti, Piero Paladini, Sabino Scolletta
Background: In the treatment of malignant pleural mesothelioma the Hyperthermic Intra THOracic Chemotherapy (HITHOC) can improve the efficacy of pleurectomy and decortication with a local cytotoxic effect. However its biological impact in patient's hemodynamic and microcirculatory changes were rarely investigated. Aim of this study is to describe our experience with HITHOC after pleurectomy and decortication evaluating the role of sublingual video-microscopy in assessing the microcirculatory changes in the perioperative period...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29502379/-the-option-of-critical-patients-with-cancer-for-icu
#6
R Xia, D H Wang
With the improvement of diagnosis and treatment, tumor has become a chronic disease, and an increasing number of older patients will live with tumors. This change has led to an increase in demand for intensive care unit (ICU) and a challenge to the traditional ICU treatment concept. The option of ICU consists of two parts. The first is the option for admission. Since classic predictors of mortality are no longer relevant, we suggest broadening the criteria for ICU admission. Patients during the first course of cancer therapies should be treated with a full-code status similar to that of other patients without malignancy...
February 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29480751/cancer-patients-dying-in-the-intensive-care-units-and-access-to-palliative-care
#7
Mathilde Ledoux, Colombe Tricou, Maxime Roux, Soazic Dreano-Hartz, Murielle Ruer, Marilène Filbet
BACKGROUND: In France, cancer has become the leading cause of death. Intensive care units (ICU) focus on survival, which may not be an appropriate setting to provide palliative care (PC) as needed by cancer patients and families. OBJECTIVE: To describe the cancer patients who died in the ICU in 2010 in a French academic medical center. DESIGN: Retrospective study Measurements: We reviewed medical records of all cancer patients who died in the ICU in 2010...
February 26, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29474336/endothelial-cell-specific-molecule-1-in-critically-ill-patients-with-hematologic-malignancy
#8
Lara Zafrani, Matthieu Resche-Rigon, Nathalie De Freitas Caires, Alexandre Gaudet, Daniel Mathieu, Erika Parmentier-Decrucq, Virginie Lemiale, Djamel Mokart, Frédéric Pène, Achille Kouatchet, Julien Mayaux, François Vincent, Martine N'yunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Anne-Pascale Meert, Dominique Benoit, Michael Darmon, Elie Azoulay
OBJECTIVES: To assess whether serum concentration of endothelial cell-specific molecule-1 (Endocan) at ICU admission is associated with the use of ICU resources and outcomes in critically ill hematology patients. DESIGN: Prospective multicenter cohort study. SETTING: Seventeen ICUs in France and Belgium. PATIENTS: Seven hundred forty-four consecutive critically ill hematology patients; 72 critically ill septic patients without hematologic malignancy; 276 healthy subjects...
March 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29394633/-a-case-of-shock-due-to-nabptx-administration-successfully-treated-with-cytokine-adsorption-therapy
#9
Katsuhiro Yoshikawa, Daigo Yamamoto, Yu Tsubota, Noriko Sueoka, Tsukuru Chiba, Mariko Ishizuka, Masanori Kon
The patient was a 71-year-old woman with ER(+), PgR(-), HER2(3+), and Ki-674 2% breast cancer. After surgery for left breast cancer(Bt+Ax), epirubicin, cyclophosphamide therapy was administered as postoperative adjuvant chemotherapy, and nabPTX plus trastuzumab therapy was started sequentially. The patient was hospitalized due to severe neutrope- nia(neutrophils 0/mm3)from nabPTX, but her condition stabilized after admission. However, the patient suddenly went into shock after 3 days and was thus transferred to the ICU...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29373361/urgent-chemotherapy-in-sepsis-like-shock-related-to-hematologic-malignancies
#10
Marlène Cherruault, Marielle Le Goff, Jérôme Tamburini, Frédéric Pène
OBJECTIVES: Hematologic malignancies may result in multiple organ involvement including pulmonary and renal dysfunctions, and the less common acute circulatory failure. We herein addressed the outcome of patients with sepsis-like shock related to aggressive hematologic malignancies. DESIGN: A 10-year (2007-2016) monocenter retrospective study. SETTINGS: A medical ICU in a tertiary care center. PATIENTS: Patients with circulatory shock requiring vasopressors and who subsequently received chemotherapy...
January 25, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29368008/-cancer-patients-in-operative-intensive-care-medicine
#11
REVIEW
T Annecke, A Hohn, B Böll, M Kochanek
Cancer is one of the leading causes of death worldwide. New targeted and individualized therapies and drugs provide a survival benefit for an increasing number of patients, but can also cause severe side effects. An increasing number of oncology patients are admitted to intensive care units (ICU) because of cancer-related complications or treatment-associated side effects. Postoperative care, respiratory distress and sepsis are the leading causes for admission. Tumor mass syndromes and tumor lysis may require urgent treatment...
January 24, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29362918/clinical-characteristics-and-outcomes-of-cancer-patients-requiring-intensive-care-unit-admission-a-prospective-study
#12
Frank Daniel Martos-Benítez, Andrés Soto-García, Anarelys Gutiérrez-Noyola
PURPOSE: The study was aimed to describe the characteristics of cancer patients admitted to the oncological ICU and to identify clinical features associated with outcomes. METHODS: This is a prospective study (January 2014 to December 2015) of 522 cancer patients consecutively admitted to the oncological ICU. Patients with a length of oncological ICU stay ≤ 1 day were excluded. Demographic and clinical variables were obtained at oncological ICU admission...
January 23, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29281852/evolution-of-cystectomy-care-over-an-11-year-period-in-a-high-volume-tertiary-referral-centre
#13
Aldo Brassetti, Axel Möller, Oscar Laurin, Jonas Höijer, Christofer Adding, Ayako Miyakawa, Abolfazl Hosseini, Peter Wiklund
OBJECTIVES: To describe the evolution in radical cystectomy (RC) care over 11 years at a referral centre. PATIENTS AND METHODS: The clinical data of patients undergoing either open RC (ORC) or robot-assisted RC (RARC) for cT1-4aN0M0 bladder cancer (BCa) at our centre between January 2006 and December 2016 were retrospectively evaluated. Crude and propensity score-weighted log-binomial regression analyses were conducted to assess the association between pre- and peri-operative variables and the risk of reoperation, intensive care unit (ICU) admission and death <90 days after RC...
December 27, 2017: BJU International
https://www.readbyqxmd.com/read/29227565/limited-utility-of-routine-chest-x-ray-in-initial-evaluation-of-neutropenic-fever-in-patients-with-haematological-diseases-undergoing-chemotherapy
#14
Ortis Estacio, Zoe Loh, Amy Baker, Geoff Chong, Andrew Grigg, Leonid Churilov, Eliza A Hawkes
BACKGROUND: Routine chest X-Ray (CXR) is recommended for neutropenic fever(NF) management however its role is relatively understudied in haematology patients. METHODS: Retrospective, single-centre analysis of haematology patients admitted with NF between January 2011-December 2015. Baseline demographics, treatment details and outcomes were collected from electronic patient records. CXRs underwent independent radiology review. Primary endpoints were proportion of NF episodes in which CXR detected a probable chest infection in the absence of respiratory symptoms/signs, and/or resulted in a change in antibiotic management...
December 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29118858/characteristics-and-predictors-of-mortality-of-patients-with-hematologic-malignancies-requiring-invasive-mechanical-ventilation
#15
Hasan M Al-Dorzi, Haya Al Orainni, Faten Al Eid, Haytham Tlayjeh, Abedalrahman Itani, Ayman Al Hejazi, Yaseen M Arabi
RATIONALE: Acute respiratory failure (ARF) may complicate the course of hematologic malignancies (HMs). Our objective was to study the characteristics, outcomes and predictors of mortality of patients with HMs who required intubation for ARF. METHODS: This retrospective cohort study evaluated all patients with HMs who were admitted to the Intensive Care Unit (ICU) of King Abdul-Aziz Medical City-Riyadh between 2008 and 2013 and required invasive mechanical ventilation...
October 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29113549/the-final-30-days-of-life-a-study-of-patients-with-gastrointestinal-cancer-in-ontario-canada
#16
Shaila J Merchant, Katherine Lajkosz, Susan B Brogly, Christopher M Booth, Sulaiman Nanji, Sunil V Patel, Nancy N Baxter
BACKGROUND: Studies have reported overly aggressive end-of-life care (EOLC) in many cancers. We investigate trends in, and factors associated with, aggressive EOLC among patients who died of gastrointestinal (GI) cancers in Ontario, Canada. METHODS: All patients with primary cause of death from esophageal, gastric, colon, and anorectal cancer from January 2003 to December 2013 were identified through the Ontario Cancer Registry, and information was collected from linked databases...
July 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29076479/-laparoscopic-and-robot-assisted-surgery-for-locally-advanced-and-generalized-stomach-cancer
#17
A F Chernousov, T V Khorobrykh, F P Vetshev, N M Abdulkhakimov, S V Osminin, A V Dulova
AIM: To analyze the first experience of laparoscopic and robot-assisted surgery for locally advanced and generalized stomach cancer at the Burdenko Clinic of Faculty Surgery. MATERIAL AND METHODS: Since 2011 27 laparoscopic and 2 robot-assisted operations for locally advanced and generalized stomach cancer have been performed in our hospital. Mean age of patients was 62.1±10 years. There were 19 men and 10 women. RESULTS: There were 11 gastrectomies with abdominal esophageal resection and 18 Billroth I subtotal resections...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29018838/adverse-post-operative-outcomes-in-jehovah-s-witnesses-with-gynecologic-cancer-within-30-days-of-surgery-a-single-institution-review-of-36-cases
#18
Laura J Moulton, Peter G Rose, Haider Mahdi
Rates of blood transfusion are reported as high as 32% in women undergoing major gynecologic cancer surgery. Therefore, care of the gynecologic oncology patient who refuses blood products, such as Jehovah's witnesses, can pose a unique challenge. The objective of this study was to determine rate of adverse post-operative outcomes within 30 days of surgery in Jehovah's witnesses with gynecologic cancer. This was a retrospective cohort study of Jehovah's witnesses undergoing laparotomy or minimally invasive surgery (MIS) for gynecologic cancer at a single institution...
November 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28988028/intensive-care-admissions-among-ovarian-cancer-patients-treated-with-primary-debulking-surgery-and-neoadjuvant-chemotherapy-interval-debulking-surgery
#19
Kristen Pepin, Amy Bregar, Michelle Davis, Alexander Melamed, Emily Hinchcliff, Allison Gockley, Neil Horowitz, Marcela G Del Carmen
OBJECTIVE: Admissions to intensive care units (ICU) are costly, but are necessary for some patients undergoing radical cancer surgery. When compared to primary debulking surgery (PDS), neoadjuvant chemotherapy (NACT) with interval debulking surgery, is associated with less peri-operative morbidity. In this study, we compare rates, indications and lengths of ICU stays among ovarian cancer patients admitted to the ICU within 30days of cytoreduction, either primary or interval. METHODS: A retrospective chart review was performed of patients with stage III-IV ovarian cancer who underwent surgical cytoreduction at two large academic medical centers between 2010 and 2014...
December 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28985622/outcomes-and-changes-in-code-status-of-patients-with-acute-myeloid-leukemia-undergoing-induction-chemotherapy-who-were-transferred-to-the-intensive-care-unit
#20
Tamjeed Ahmed, Abby L Koch, Scott Isom, Heidi D Klepin, Jonathan M Bishop, Leslie R Ellis, Dmitriy Berenzon, Dianna Howard, Susan Lyerly, Bayard L Powell, Timothy S Pardee
Patients with Acute Myeloid Leukemia (AML) have compromised marrow function and chemotherapy causes further suppression. As a result complications are frequent, and patients may require admission to the intensive care unit (ICU). How codes status changes when these events occur and how those changes influence outcome are largely unknown. Outcomes for adult patients with AML, undergoing induction chemotherapy, and transferred to the ICU between January 2000 and December 2013 were analyzed. 94 patients were included...
November 2017: Leukemia Research
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