Display options
Cite
Ruschulte H, Shi S, Tseng WW, et al. Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases. BMC Anesthesiol. 2013;13(1):15doi: 10.1186/1471-2253-13-15.
Ruschulte, H., Shi, S., Tseng, W. W., Kolodzie, K., Crawford, P. C., Schneider, D. B., Kashani-Sabet, M., Minor, D., Apfel, C., & Leong, S. P. (2013). Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases. BMC anesthesiology, 13(1), 15. https://doi.org/10.1186/1471-2253-13-15
Ruschulte, Heiner, et al. "Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases." BMC anesthesiology vol. 13,1 (2013): 15. doi: https://doi.org/10.1186/1471-2253-13-15
Ruschulte H, Shi S, Tseng WW, Kolodzie K, Crawford PC, Schneider DB, Kashani-Sabet M, Minor D, Apfel C, Leong SP. Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases. BMC Anesthesiol. 2013 Jul 17;13(1):15. doi: 10.1186/1471-2253-13-15. PMID: 23865420; PMCID: PMC3726295.
Copy Download .nbib Format: NLM
Share it on

BMC Anesthesiol. 2013 Jul 17;13(1):15. doi: 10.1186/1471-2253-13-15.

Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases.

BMC anesthesiology

Heiner Ruschulte, Serena Shi, William W Tseng, Kerstin Kolodzie, Philip C Crawford, Darren B Schneider, Mohammed Kashani-Sabet, David Minor, Christian Apfel, Stanley Pl Leong

Affiliations

  1. Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA. [email protected].

PMID: 23865420 PMCID: PMC3726295 DOI: 10.1186/1471-2253-13-15

Abstract

BACKGROUND: Hyperthermic isolated limb perfusion (HILP) is used for patients with intractable or extensive in-transit metastatic melanoma of the limb to deliver high concentrations of cytotoxic agents to the affected limb and offers a treatment option in a disease stage with a poor prognosis when no treatment is given.

METHODS: In a retrospective chart review of 17 cases, we studied the anesthetic and hemodynamic changes during HILP and its management.

RESULTS: HILP was well tolerated except in one case that is described herein. We present summary data of all cases undergoing upper and lower limb perfusion, discuss our current clinical practice of preoperative, perioperative and intraoperative patient care including the management of HILP circuit.

CONCLUSION: HILP is a challenging procedure, and requires a team effort including the surgical team, anesthesia care providers, perfusionists and nurses. Intraoperatively, invasive hemodynamic and metabolic monitoring is indispensable to manage significant hemodynamic and metabolic changes due to fluid shifts and release of cytokines.

References

  1. J Am Coll Surg. 2009 May;208(5):706-15; discussion 715-7 - PubMed
  2. Cancer. 1967 Sep;20(9):1351-81 - PubMed
  3. Eur J Cancer Clin Oncol. 1982 Oct;18(10):905-10 - PubMed
  4. Ann Surg Oncol. 2011 Jul;18(7):1877-83 - PubMed
  5. J Surg Oncol. 2011 May 1;103(6):538-49 - PubMed
  6. J Immunother. 2001 Jul-Aug;24(4):354-62 - PubMed
  7. Perfusion. 1996 Sep;11(5):395-9 - PubMed
  8. J Extra Corpor Technol. 2005 Dec;37(4):396-9 - PubMed
  9. Eur J Surg Oncol. 2001 Jun;27(4):390-5 - PubMed
  10. Expert Rev Anticancer Ther. 2009 Nov;9(11):1599-609 - PubMed
  11. J Extra Corpor Technol. 2002 Jun;34(2):130-43 - PubMed
  12. Ann Surg. 1958 Oct;148(4):616-32 - PubMed
  13. Ann Surg Oncol. 2001 Aug;8(7):564-5 - PubMed
  14. Cancer. 2010 Sep 1;116(17):4139-46 - PubMed
  15. Surg Oncol Clin N Am. 2008 Oct;17(4):785-94, viii-ix - PubMed
  16. Int J Hyperthermia. 2008 May;24(3):301-9 - PubMed
  17. CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49 - PubMed
  18. Can Anaesth Soc J. 1984 Sep;31(5):552-8 - PubMed
  19. J Exp Clin Cancer Res. 2008 Nov 12;27:67 - PubMed
  20. Ann Surg Oncol. 2008 Nov;15(11):3003-13 - PubMed
  21. Ann Surg. 1950 Oct;132(4):811-32 - PubMed
  22. J Cardiothorac Vasc Anesth. 1995 Dec;9(6):722-4 - PubMed
  23. Ann Surg. 2007 Apr;245(4):591-6 - PubMed
  24. Arch Surg. 2003 Jan;138(1):17-25 - PubMed
  25. Crit Care Med. 2000 Apr;28(4):1040-6 - PubMed
  26. Ann Oncol. 2005 Jul;16(7):1061-8 - PubMed
  27. Int J Hyperthermia. 2008 May;24(3):219-25 - PubMed

Publication Types