Anesthesia and Perioperative Management of Hepatic Metastases to CRC Patients in Liver Resection. Our Experience.

Abstract

Background: The patients with colorectal adenocarcinoma very often developed hepatic metastases. Resection of them still remains the best treatment of disease. Hepatectomy carried about 20% mortality rate. The most important intraoperative factor is major hemorrhage and hypotension and postoperatively the main reasons are hemorrhage, coagulopathy, renal failure, pulmonary, and cardiac disturbance till biliary fistula and liver failure. Anesthesia and perioperative management have resulted in diminished value of mortality and morbidity at the same time. Aim: The aim of this study is to submit our experience in anesthesia and perioperative management in liver resection of hepatic metastases in CRC patients. Material and Methods: In that retrospective study we enrolled 6 patients ASAII- III, from January to July 2019. All patients treated for liver malignancy diagnosis after colorectal carcinoma in elective surgery and received general anesthesia with fentanyl 1-2μg/kg/h, profolol 4.0μg/kg/min via target controlled infusion and vecuronium 0.001mg/kg/min and sevofluran 2%. All patients are monitored with continuous central venous pressure(CVP). We recorded mean artery pressure (MAP), heart rate (HR), CVP, amount of transfusion, incidence of complications and discharge from intensive care and hospital. Results: Female/male report was 66,6% vs. 33.4%. The ages of patients were 53-72 years with a mean ± SD age of 65.1 ± 9.5 years. CVP was 0-5. Amount of blood was 2.5 unite during intervention. Average of days in intensive care was 3.83. Renal compromised was 3%. Ascites and edema was 50%. All patients were discharged home after 14.66 days. Conclusion: Optimizing hemodynamic and fluid administration and reduced the administration of blood therapy using low CVP (0-5).

Keywords

• blood transfusion
• CVP
• CRC
• liver surgery
• perioperative management