Restrictive Intraoperative Fluid Therapy is Associated with Decreased Morbidity and Length of Stay Following Hyperthermic Intraperitoneal Chemoperfusion
Background Recent data have demonstrated multiple benefits of intra- and postoperative fluid restriction in major abdominal surgery; however, data regarding the outcomes of fluid restriction in cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are limited. This study...
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| Veröffentlicht in: | Annals of surgical oncology 2019-02, Vol.26 (2), p.490-496 |
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| creator | Hendrix, Ryan J. Damle, Aneel Williams, Chloe Harris, Ariana Spanakis, Spiro Lambert, Donald H. Lambert, Laura A. |
| description | Background
Recent data have demonstrated multiple benefits of intra- and postoperative fluid restriction in major abdominal surgery; however, data regarding the outcomes of fluid restriction in cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are limited. This study evaluates the safety and short-term clinical outcomes of restricted intraoperative fluid therapy in CRS/HIPEC.
Methods
This was a single-institution, retrospective review of all CRS/HIPEC procedures performed at the University of Massachusetts Medical School between January 2009 and July 2017. Recorded variables included demographics, intraoperative factors, 60-day postoperative complications, and length of stay (LOS). Outcomes based on the use of intraoperative permissive fluid therapy (PFT) versus restrictive fluid therapy (RFT) were compared.
Results
Overall, 169 CRS/HIPEC cases were performed during the study period; 84 were managed with PFT and 85 were managed with RFT. No significant differences were identified in patient demographics. There was a decrease in intraoperative administration of crystalloid (8.0 vs. 4.4 L,
p
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| doi_str_mv | 10.1245/s10434-018-07092-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22927883</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2149463202</sourcerecordid><originalsourceid>FETCH-LOGICAL-c403t-e6be3ff45bbc1e4cdea48dedff9117fc86c525761ba3ad12833fb77290ac423f3</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0EomXgBVggS2zYBPybn2U1ZdpKg5CgrC3HuZ5xlbEH26HKm_C4dZvS7tjYPr7fPVf2Qeg9JZ8pE_JLokRwURHaVqQhHavmF-iUynIl6pa-LGdSt1XHanmC3qR0QwhtOJGv0UlZqawbcor-_oCUozPZ_QF85XPU4QhRP8jNOLkBX--LPs7YJXyWUjBOZxjwrct7fA4mgk5Ffguxd4PLM9Z-wFvwu1IOFv_MesabMI7h1vkdvpyLeS6GB2eWaUW7HDzoEa_3cLgfbqfkgn-LXlk9Jnj3uK_Qr83X6_Vltf1-cbU-21ZGEJ4rqHvg1grZ94aCMANo0Q4wWNtR2ljT1kYy2dS011wPlLWc275pWEe0EYxbvkIfF9-QslPJuAxmb4L3YLJirGNNW3pW6NNCHWP4PZUvUweXDIyj9hCmpBiVRLKa1_LZ8Am9CVP05Q2FEp2oOSOsUGyhTAwpRbDqGN1Bx1lRou7TVUu6qqSrHtJVc2n68Gg99QcYnlr-xVkAvgCplPwO4vPs_9jeAexQs9o</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2149463202</pqid></control><display><type>article</type><title>Restrictive Intraoperative Fluid Therapy is Associated with Decreased Morbidity and Length of Stay Following Hyperthermic Intraperitoneal Chemoperfusion</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Hendrix, Ryan J. ; Damle, Aneel ; Williams, Chloe ; Harris, Ariana ; Spanakis, Spiro ; Lambert, Donald H. ; Lambert, Laura A.</creator><creatorcontrib>Hendrix, Ryan J. ; Damle, Aneel ; Williams, Chloe ; Harris, Ariana ; Spanakis, Spiro ; Lambert, Donald H. ; Lambert, Laura A.</creatorcontrib><description>Background
Recent data have demonstrated multiple benefits of intra- and postoperative fluid restriction in major abdominal surgery; however, data regarding the outcomes of fluid restriction in cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are limited. This study evaluates the safety and short-term clinical outcomes of restricted intraoperative fluid therapy in CRS/HIPEC.
Methods
This was a single-institution, retrospective review of all CRS/HIPEC procedures performed at the University of Massachusetts Medical School between January 2009 and July 2017. Recorded variables included demographics, intraoperative factors, 60-day postoperative complications, and length of stay (LOS). Outcomes based on the use of intraoperative permissive fluid therapy (PFT) versus restrictive fluid therapy (RFT) were compared.
Results
Overall, 169 CRS/HIPEC cases were performed during the study period; 84 were managed with PFT and 85 were managed with RFT. No significant differences were identified in patient demographics. There was a decrease in intraoperative administration of crystalloid (8.0 vs. 4.4 L,
p
< 0.01), colloid (900 vs. 300 mL,
p
< 0.01), and blood transfusion (0.26 vs. 0.04 units,
p
< 0.01) in the RFT cohort. LOS was reduced from 11.5 to 9.7 days (
p
< 0.01) and the incidence of any 60-day complication decreased from 45 to 28% (
p
= 0.02) in the RFT group. The overall 90-day mortality rate was 0.6% (
n
= 1). Adjusted logistic regression demonstrated the odds of having a Clavien–Dindo grade III or higher complication was 0.31 (95% confidence interval 0.10–0.95) with RFT.
Conclusion
Intraoperative RFT with standard anesthesia monitoring devices can be safely used in CRS/HIPEC and is associated with a decreased LOS and decreased rate of postoperative complications.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-018-07092-y</identifier><identifier>PMID: 30515670</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>60 APPLIED LIFE SCIENCES ; ANESTHESIA ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; BLOOD ; Blood transfusion ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures - adverse effects ; Demography ; DISEASE INCIDENCE ; Female ; Fluid Therapy ; FLUIDS ; Follow-Up Studies ; Humans ; Hyperthermia, Induced - adverse effects ; Intraoperative Care ; Length of Stay - statistics & numerical data ; Male ; MASSACHUSETTS ; Medicine ; Medicine & Public Health ; Middle Aged ; MONITORING ; Morbidity ; MORTALITY ; Neoplasms - epidemiology ; Neoplasms - pathology ; Neoplasms - therapy ; Oncology ; Peritoneal Neoplasms - epidemiology ; Peritoneal Neoplasms - secondary ; Peritoneal Neoplasms - therapy ; Peritoneal Surface Malignancy ; Postoperative Complications - etiology ; Postoperative Complications - prevention & control ; Prognosis ; Retrospective Studies ; SURGERY ; Surgical Oncology</subject><ispartof>Annals of surgical oncology, 2019-02, Vol.26 (2), p.490-496</ispartof><rights>Society of Surgical Oncology 2018</rights><rights>Annals of Surgical Oncology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-e6be3ff45bbc1e4cdea48dedff9117fc86c525761ba3ad12833fb77290ac423f3</citedby><cites>FETCH-LOGICAL-c403t-e6be3ff45bbc1e4cdea48dedff9117fc86c525761ba3ad12833fb77290ac423f3</cites><orcidid>0000-0002-2176-4283</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-018-07092-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-018-07092-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30515670$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22927883$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Hendrix, Ryan J.</creatorcontrib><creatorcontrib>Damle, Aneel</creatorcontrib><creatorcontrib>Williams, Chloe</creatorcontrib><creatorcontrib>Harris, Ariana</creatorcontrib><creatorcontrib>Spanakis, Spiro</creatorcontrib><creatorcontrib>Lambert, Donald H.</creatorcontrib><creatorcontrib>Lambert, Laura A.</creatorcontrib><title>Restrictive Intraoperative Fluid Therapy is Associated with Decreased Morbidity and Length of Stay Following Hyperthermic Intraperitoneal Chemoperfusion</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Recent data have demonstrated multiple benefits of intra- and postoperative fluid restriction in major abdominal surgery; however, data regarding the outcomes of fluid restriction in cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are limited. This study evaluates the safety and short-term clinical outcomes of restricted intraoperative fluid therapy in CRS/HIPEC.
Methods
This was a single-institution, retrospective review of all CRS/HIPEC procedures performed at the University of Massachusetts Medical School between January 2009 and July 2017. Recorded variables included demographics, intraoperative factors, 60-day postoperative complications, and length of stay (LOS). Outcomes based on the use of intraoperative permissive fluid therapy (PFT) versus restrictive fluid therapy (RFT) were compared.
Results
Overall, 169 CRS/HIPEC cases were performed during the study period; 84 were managed with PFT and 85 were managed with RFT. No significant differences were identified in patient demographics. There was a decrease in intraoperative administration of crystalloid (8.0 vs. 4.4 L,
p
< 0.01), colloid (900 vs. 300 mL,
p
< 0.01), and blood transfusion (0.26 vs. 0.04 units,
p
< 0.01) in the RFT cohort. LOS was reduced from 11.5 to 9.7 days (
p
< 0.01) and the incidence of any 60-day complication decreased from 45 to 28% (
p
= 0.02) in the RFT group. The overall 90-day mortality rate was 0.6% (
n
= 1). Adjusted logistic regression demonstrated the odds of having a Clavien–Dindo grade III or higher complication was 0.31 (95% confidence interval 0.10–0.95) with RFT.
Conclusion
Intraoperative RFT with standard anesthesia monitoring devices can be safely used in CRS/HIPEC and is associated with a decreased LOS and decreased rate of postoperative complications.</description><subject>60 APPLIED LIFE SCIENCES</subject><subject>ANESTHESIA</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>BLOOD</subject><subject>Blood transfusion</subject><subject>Chemotherapy, Cancer, Regional Perfusion</subject><subject>Combined Modality Therapy</subject><subject>Cytoreduction Surgical Procedures - adverse effects</subject><subject>Demography</subject><subject>DISEASE INCIDENCE</subject><subject>Female</subject><subject>Fluid Therapy</subject><subject>FLUIDS</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hyperthermia, Induced - adverse effects</subject><subject>Intraoperative Care</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>MASSACHUSETTS</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>MONITORING</subject><subject>Morbidity</subject><subject>MORTALITY</subject><subject>Neoplasms - epidemiology</subject><subject>Neoplasms - pathology</subject><subject>Neoplasms - therapy</subject><subject>Oncology</subject><subject>Peritoneal Neoplasms - epidemiology</subject><subject>Peritoneal Neoplasms - secondary</subject><subject>Peritoneal Neoplasms - therapy</subject><subject>Peritoneal Surface Malignancy</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>SURGERY</subject><subject>Surgical Oncology</subject><issn>1068-9265</issn><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc1u1DAUhS0EomXgBVggS2zYBPybn2U1ZdpKg5CgrC3HuZ5xlbEH26HKm_C4dZvS7tjYPr7fPVf2Qeg9JZ8pE_JLokRwURHaVqQhHavmF-iUynIl6pa-LGdSt1XHanmC3qR0QwhtOJGv0UlZqawbcor-_oCUozPZ_QF85XPU4QhRP8jNOLkBX--LPs7YJXyWUjBOZxjwrct7fA4mgk5Ffguxd4PLM9Z-wFvwu1IOFv_MesabMI7h1vkdvpyLeS6GB2eWaUW7HDzoEa_3cLgfbqfkgn-LXlk9Jnj3uK_Qr83X6_Vltf1-cbU-21ZGEJ4rqHvg1grZ94aCMANo0Q4wWNtR2ljT1kYy2dS011wPlLWc275pWEe0EYxbvkIfF9-QslPJuAxmb4L3YLJirGNNW3pW6NNCHWP4PZUvUweXDIyj9hCmpBiVRLKa1_LZ8Am9CVP05Q2FEp2oOSOsUGyhTAwpRbDqGN1Bx1lRou7TVUu6qqSrHtJVc2n68Gg99QcYnlr-xVkAvgCplPwO4vPs_9jeAexQs9o</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Hendrix, Ryan J.</creator><creator>Damle, Aneel</creator><creator>Williams, Chloe</creator><creator>Harris, Ariana</creator><creator>Spanakis, Spiro</creator><creator>Lambert, Donald H.</creator><creator>Lambert, Laura A.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>OTOTI</scope><orcidid>https://orcid.org/0000-0002-2176-4283</orcidid></search><sort><creationdate>20190201</creationdate><title>Restrictive Intraoperative Fluid Therapy is Associated with Decreased Morbidity and Length of Stay Following Hyperthermic Intraperitoneal Chemoperfusion</title><author>Hendrix, Ryan J. ; Damle, Aneel ; Williams, Chloe ; Harris, Ariana ; Spanakis, Spiro ; Lambert, Donald H. ; Lambert, Laura A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-e6be3ff45bbc1e4cdea48dedff9117fc86c525761ba3ad12833fb77290ac423f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>60 APPLIED LIFE SCIENCES</topic><topic>ANESTHESIA</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>BLOOD</topic><topic>Blood transfusion</topic><topic>Chemotherapy, Cancer, Regional Perfusion</topic><topic>Combined Modality Therapy</topic><topic>Cytoreduction Surgical Procedures - adverse effects</topic><topic>Demography</topic><topic>DISEASE INCIDENCE</topic><topic>Female</topic><topic>Fluid Therapy</topic><topic>FLUIDS</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hyperthermia, Induced - adverse effects</topic><topic>Intraoperative Care</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>MASSACHUSETTS</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>MONITORING</topic><topic>Morbidity</topic><topic>MORTALITY</topic><topic>Neoplasms - epidemiology</topic><topic>Neoplasms - pathology</topic><topic>Neoplasms - therapy</topic><topic>Oncology</topic><topic>Peritoneal Neoplasms - epidemiology</topic><topic>Peritoneal Neoplasms - secondary</topic><topic>Peritoneal Neoplasms - therapy</topic><topic>Peritoneal Surface Malignancy</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>SURGERY</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hendrix, Ryan J.</creatorcontrib><creatorcontrib>Damle, Aneel</creatorcontrib><creatorcontrib>Williams, Chloe</creatorcontrib><creatorcontrib>Harris, Ariana</creatorcontrib><creatorcontrib>Spanakis, Spiro</creatorcontrib><creatorcontrib>Lambert, Donald H.</creatorcontrib><creatorcontrib>Lambert, Laura A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hendrix, Ryan J.</au><au>Damle, Aneel</au><au>Williams, Chloe</au><au>Harris, Ariana</au><au>Spanakis, Spiro</au><au>Lambert, Donald H.</au><au>Lambert, Laura A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Restrictive Intraoperative Fluid Therapy is Associated with Decreased Morbidity and Length of Stay Following Hyperthermic Intraperitoneal Chemoperfusion</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>26</volume><issue>2</issue><spage>490</spage><epage>496</epage><pages>490-496</pages><issn>1068-9265</issn><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Background
Recent data have demonstrated multiple benefits of intra- and postoperative fluid restriction in major abdominal surgery; however, data regarding the outcomes of fluid restriction in cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are limited. This study evaluates the safety and short-term clinical outcomes of restricted intraoperative fluid therapy in CRS/HIPEC.
Methods
This was a single-institution, retrospective review of all CRS/HIPEC procedures performed at the University of Massachusetts Medical School between January 2009 and July 2017. Recorded variables included demographics, intraoperative factors, 60-day postoperative complications, and length of stay (LOS). Outcomes based on the use of intraoperative permissive fluid therapy (PFT) versus restrictive fluid therapy (RFT) were compared.
Results
Overall, 169 CRS/HIPEC cases were performed during the study period; 84 were managed with PFT and 85 were managed with RFT. No significant differences were identified in patient demographics. There was a decrease in intraoperative administration of crystalloid (8.0 vs. 4.4 L,
p
< 0.01), colloid (900 vs. 300 mL,
p
< 0.01), and blood transfusion (0.26 vs. 0.04 units,
p
< 0.01) in the RFT cohort. LOS was reduced from 11.5 to 9.7 days (
p
< 0.01) and the incidence of any 60-day complication decreased from 45 to 28% (
p
= 0.02) in the RFT group. The overall 90-day mortality rate was 0.6% (
n
= 1). Adjusted logistic regression demonstrated the odds of having a Clavien–Dindo grade III or higher complication was 0.31 (95% confidence interval 0.10–0.95) with RFT.
Conclusion
Intraoperative RFT with standard anesthesia monitoring devices can be safely used in CRS/HIPEC and is associated with a decreased LOS and decreased rate of postoperative complications.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30515670</pmid><doi>10.1245/s10434-018-07092-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2176-4283</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2019-02, Vol.26 (2), p.490-496 |
| issn | 1068-9265 1534-4681 1534-4681 |
| language | eng |
| recordid | cdi_osti_scitechconnect_22927883 |
| source | MEDLINE; SpringerLink Journals |
| subjects | 60 APPLIED LIFE SCIENCES ANESTHESIA Antineoplastic Combined Chemotherapy Protocols - therapeutic use BLOOD Blood transfusion Chemotherapy, Cancer, Regional Perfusion Combined Modality Therapy Cytoreduction Surgical Procedures - adverse effects Demography DISEASE INCIDENCE Female Fluid Therapy FLUIDS Follow-Up Studies Humans Hyperthermia, Induced - adverse effects Intraoperative Care Length of Stay - statistics & numerical data Male MASSACHUSETTS Medicine Medicine & Public Health Middle Aged MONITORING Morbidity MORTALITY Neoplasms - epidemiology Neoplasms - pathology Neoplasms - therapy Oncology Peritoneal Neoplasms - epidemiology Peritoneal Neoplasms - secondary Peritoneal Neoplasms - therapy Peritoneal Surface Malignancy Postoperative Complications - etiology Postoperative Complications - prevention & control Prognosis Retrospective Studies SURGERY Surgical Oncology |
| title | Restrictive Intraoperative Fluid Therapy is Associated with Decreased Morbidity and Length of Stay Following Hyperthermic Intraperitoneal Chemoperfusion |
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