Intracompartmental pressure during hyperthermic isolated limb perfusion for melanoma and sarcoma

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
P HohenbergerP M Schlag

Abstract

Side effects of isolated limb perfusion (ILP) include rhabdomyolysis, paresthesia, or nerve palsy. The increase in intracompartmental pressure during ILP is thought to be linked to neuro- and muscular toxicity, and fasciotomy is recommended for protection. In 24 patients, intracompartmental pressure was measured. A flexible 5 F probe was placed into the non-tumour-bearing compartment of the perfused limb. Interstitial fluid pressure was measured using a piezoresistant tip. Compartmental pressure values were continuously recorded during and after ILP. The drugs used were a combination of doxorubicin, cisplatinum and melphalan or rhTNF-alpha combined with melphalan. The median overall compartmental pressure prior to ILP was 13 mmHg (range: 11-21 mmHg); during the heat-up phase the median pressure rose to 28 mmHg. During therapeutic perfusion a further increase could be documented and the maximum pressure measured was 90 mmHg; the median of the pressure maxima of all patients was 34 mmHg. During wash-out, at the end of the perfusion, a clear reduction in compartment pressures could be observed and the median dropped to a value of 27 mmHg. In all patients a continuous decrease in compartmental pressure could be recorded, reaching t...Continue Reading

References

Oct 1, 1982·European Journal of Cancer & Clinical Oncology·J WieberdinkG A Olthuis
Nov 1, 1993·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·A R HargensW H Akeson

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Citations

Apr 21, 1998·Seminars in Surgical Oncology·B C VrouenraetsB B Kroon
Sep 1, 1996·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·H S KoopsP Hohenberger
May 22, 1998·Breast Cancer Research and Treatment·P HohenbergerP M Schlag
May 10, 2011·Current Problems in Surgery·Amira SankiJohn F Thompson
Aug 30, 2008·Surgical Oncology Clinics of North America·Harald Joan Hoekstra
Dec 1, 2009·Orthopaedics & Traumatology, Surgery & Research : OTSR·A DrouetF Chauvin
Apr 9, 2008·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·G TaegerS Ruchholtz
Aug 29, 2019·Advanced Drug Delivery Reviews·Brianna CoteAdam W G Alani

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