Effect of Cilastatin on Cisplatin-Induced Nephrotoxicity in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy

Cisplatin is one of the most widely used chemotherapeutic agents in oncology, although its nephrotoxicity limits application and dosage. We present the results of a clinical study on prophylaxis of cisplatin-induced nephrotoxicity in patients with peritoneal carcinomatosis undergoing cytoreduction and hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC-cisplatin). Prophylaxis was with imipenem/cilastatin. Cilastatin is a selective inhibitor of renal dehydropeptidase I in the proximal renal tubule cells that can reduce the nephrotoxicity of cisplatin. Unfortunately, cilastatin is not currently marketed alone, and can only be administered in combination with imipenem. The study has a retrospective part that serves as a control (n = 99 patients receiving standard surgical prophylaxis) and a prospective part with imipenem/cilastatin prophylaxis corresponding to the study group (n = 85 patients). In both groups, we collected specific data on preoperative risk factors of renal damage, fluid management, hemodynamic control, and urine volume during surgery (including the hyperthermic chemotherapy perfusion), as well as data on hemodynamic and renal function during the first seven days after surgery. The main finding of the study is that cilastatin may exert a nephroprotective effect in patients with peritoneal carcinomatosis undergoing cytoreduction and hyperthermic intraperitoneal cisplatin perfusion. Creatinine values remained lower than in the control group (ANOVA test, p = 0.037). This translates into easier management of these patients in the postoperative period, with significantly shorter intensive care unit (ICU) and hospital stay.

The Experience of Nursing Intervention for Cesarean Section Pregnancy

<p><strong>Objective: </strong>To explore the effects of nursing care on the patients subjected to cesarean and during perioperative of uterine incision. <strong>Method: </strong>A total of 98 cases of early pregnancy after cesarean in our hospital, from December 2013 to December 2014, were analyzed retrospectively. Nursing care was provided throughout the perioperative period of patients, who subjected to uterine arterial chemotherapy, perfusion and embolization. <strong>Result: </strong>Early recoveries of patients were promoted through psychological care before and after the operation, diet adjustment, nursing care and health guidance. <strong>Conclusion: </strong>Nursing care is important for patients with early pregnancy, in term of interventional therapy as it enhances treatment effect and reduces complications. Based on the result, the success rate of operation is improved and the risk is reduced. Thus, it is worth for clinical application.<strong></strong></p>