Physiotherapy in the management of patients with peritoneal carcinomatosis receiving cytoreductive surgery

• Published in: Annals of physical and rehabilitation medicine 2018-07, Vol.61, p.e289-e289
• Main Authors: Josse, L., Weyrech, J., Houzé, M.H., Habrias, R., Perez Torres, G.R., Saez Lopez, S., Foudhaili, Yelnik, A., Pocard, M.
• Format: Article
• Language: English
• Subjects: Digestive cancer; Preoperative physiotherapy
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2018.05.676

The development of multidisciplinary work around patients receiving cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) with thoracic epidural analgesia led us to articulate our reciprocal skills in a care program. Since 2012, a preoperative consultation of physiotherapy has been set up for these patients. Between 2009 and 2013, 124 patient's files have been analysed, comparing “Patient controlled epidural analgesia (PCEA) with physiotherapy” (67 patients) and “PCEA without physiotherapy” (57 patients). The reduction of the patient's apprehension of physiotherapy and mobilization contributed to the reduction of the length of stay in intensive care unit (on average 5 days instead of 7) and an early out of bed mobilization (one day gained). After 4 years of operation, we conducted a retrospective study of patient's files in order to evaluate the efficiency of this first step programme about the role of physiotherapy in this patient's care pathway. We estimated the length of stay and the way to go back home. Three hundred and sixty-six files had been analysed. Patient’ pathway had been systematically organized including this physiotherapy consultation during the month before surgery. The content of the consultation has been adapted including 3 parts leading to a real therapeutic educational program; –information on the physiotherapy that will begin the day after the surgery: respiratory mechanics, interest of early mobilization to warn the postoperative complications; –education of the patient with teaching of techniques of respiratory physiotherapy; –a notebook containing advice for improving the physical condition is given to the patient by adjusting the dosage and the intensity according to his basic state. Physiotherapy included in preoperative management is part of improving the quality of care provided to patients, allowing them a better participation in the postoperative care. This preoperative consultation had been adapted to better support the patient and his family.