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Paediatric anaesthesia · Apr 2017
Case ReportsStaged intraperitoneal brachytherapy and hyperthermic intraperitoneal chemotherapy in an adolescent: novel anesthetic challenges for pediatric anesthetists.
- Andrew D Weatherall, Tristan R Bennett, Mark Lovell, Winnie Fung, and Jonathan de Lima.
- Department of Anaesthesia, The Children's Hospital at Westmead, Sydney, Australia.
- Paediatr Anaesth. 2017 Apr 1; 27 (4): 338-345.
AbstractNewer techniques that have found a place in cancer management in adults are offered far less commonly in pediatric patients. We present a case of a patient with recurrent Wilms' tumor managed with a novel combination of cytoreductive surgery, intraperitoneal brachytherapy, and subsequent hyperthermic intraperitoneal chemotherapy. Each stage presents challenges that the pediatric anesthetist is unlikely to have faced before. Such cases require flexibility and thorough planning to manage the combination of major surgery, remote anesthesia with brachytherapy and hyperthermic chemotherapy with its potential for metabolic derangement, significant fluid shifts, analgesic care, and potential exposure of staff to cytotoxic agents. Comprehensive care can be offered in pediatric centers.© 2017 John Wiley & Sons Ltd.
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