術中腹腔內持續高熱化療導致致命心律不整之病例報告

Fatal Arrhythmia Following Intraoperative Continuous Hyperthermic Peritoneal Perfusion Chemotherapy

腹腔內持續高熱化療經常被用來控制因腹腔腫瘤局部轉移導致的大量腹水，以目前的經驗看來是有效的。先前也有許多研究腹腔內持續高熱化療的報告，多數都認為這是一項安全的作法。但在此病例中，我們於進行腹腔內持續高熱化療時，產生致命性心律不整，經三次電擊，才恢復正常心律。高熱以及腹腔化療沖洗所導致之電解質不平衡，被認為是導致心律不整之主要原因。在緊急處理後，病患於穩定狀況下完成手術。唯術後兩個月因併發腸穿孔及敗血症病故。

Continuous hyperthermic peritoneal perfusion chemotherapy (CHPPC) offers a safe alternative to manage peritoneal tumor seeding in advanced cancer patients. A 65-year-old male underwent exploratory laparotomy for advanced gastric cancer with intraabdominal carcinomatosis and massive ascites. Life-threatening dysrrhythmia of ventricular rhythm with a rate of 120 beats/min developed during the performance of intraoperative CHPPC following eradication of the main tumor. With timely cardiopulmonary resuscitation, appropriate fluid replacement, correction of electrolyte imbalance, and cooling of body temperature, the patient regained effective cardiopulmonary circulation without sequela.