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KMID : 0371319940460010122
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Journal of the Korean Surgical Society
1994 Volume.46 No. 1 p.122 ~ p.127
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Analysis of Temperature Differences in Intracavitary Hyperthermo Chemotherapeutic Perfusion Therapy(I.H.C.P) Using Closed-crucit System
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김진영
박현규/우충아/이윤헌/이상희/박은섭/박승균/송광재
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Abstract
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Heat has a one time thermo-lethal effect because of thermal resistance of surviving cells. Intracavitary hyperthermo-chemotherapeutic perfusion(IHCP) is one of the attractive methods to avoid thermotolerance developed in repeated hyperthermic
therapy.
Temperatures in each part of the body cavities are so different to keep them constantly but it is very important to maintain constant temperature in each part of the effective hyperthermic therapy.
We performed IHCP from Jan. 1990 to Dec. 1992 in 33 patients received surgery for cancer treatment. 25 out of 33 patients were stomach cancer and the others were ovary. bladder & colon cancer. Under hypothermic general anesthesia, tubes are
inserted
into the body cavities after resection of cancer masses which are connected to the closed-circuit hyperthermic perfusion system(Hyperex-P, G.C.M.Co.) and 5% lactated Ringer's solution with 10~40 microgram/ml of Mitomycin-C heated up to 45.7℃
recirculated for 2 hours. Infusion speed was 200~400ml/min and total amount of perfusate being used was 2000~40000ml. Temperatures of the body (nasopharynx), input, bladder, and each part of the intraperitoneal cavity were checked and recorded to
the
computer system(Fig. 1).
Body temperature was 32.3~34℃ at the beginning of IHCP (n=28) and almost returned to normal temperature after 60 min. But it was not exceed 38.5℃ at the end of IHCP. Input temperature was 44.5~45.7℃. Temperature difference between input and
output
was 0.4~1.5℃ in small cavities (Bladder) and was 2.1~3.5℃ in large cavity(intraperitoneum). However average temperature difference in each part of the peritoneal cavity was 1.2℃ that was the highest in right subhepatic space(42.437℃) and the
next
was in left subphrenic space and the lowest in cul-de-sac & left paragutter space(41.5~42.3℃). The temperatures of the intraperitoneal cavity became constant within 20~30min after beginning of perfusion and was maintained almost over 42℃(Fig.
2).
But
intravesical temperature was elevated immediately after beginning of perfusion and was maintained and was maintained constantely to the end of perfusion (Fig. 3). This rescults show that intracavitary temperatures are affected by input
temperature,
perfusion speed and capacity of the body cavity.
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KEYWORD
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