Anesthesia for robotic HITHOC surgery in a patient with pulmonary sarcoma: case report and literature review
Gabriel José Redondano Oliveira
Abstract
Hyperthermic intrathoracic chemotherapy (HITHOC) combined with cytoreductive surgery is an emerging treatment for selected pleural malignancies but poses major anesthetic challenges related to hyperthermia, one-lung ventilation, hemodynamic instability, and cisplatin-associated nephrotoxicity. The anesthetic management of robotic-assisted HITHOC remains poorly described. We report the perioperative management of a 61-year-old man with pulmonary metastatic leiomyosarcoma who underwent robotic cytoreductive surgery followed by HITHOC. Advanced hemodynamic monitoring, lung-protective ventilation, deep neuromuscular blockade, goal-directed fluid therapy, and nephroprotective strategies were used throughout the procedure. The patient remained hemodynamically stable without major intraoperative complications or postoperative renal dysfunction. This case highlights important anesthetic considerations for robotic HITHOC and emphasizes the role of individualized monitoring and multidisciplinary perioperative management in complex thoracic oncologic surgery.
Keywords
References
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Submitted date:
09/27/2024
Accepted date:
05/15/2026
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