I am interested in developing a trial model implementing intraperitoneal (IP) administration of heparin in GI cancer surgery (with special interest in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy -HIPEC), combining intra-operative and post-operative administrations. I would appreciate if somebody can share his/her relevant experience regarding any aspects of IP use of heparin (subtypes, doses, complications, effect on peritoneal membrane, anti-cancerous/immuno-regulating properties, etc). Thank you in advance.
Our practice is not relevant to cancer treatment, however can be of some interest. We routinely use standard Heparin 500 IU/l for a long dwell (usually it is Extraneal day-time dwell) in our pediatric PD patients from early 2000's or late 1990's - closer to two decades. Complications - none recorded. Benefits - markedly less clotting - in fact, those almost totally disappeared, though there could be also other contributing factors). Speculative - lower peritonitis rate, but the number of patients, due to the small population, is insufficient for reliable statistics. At least it is safe in given doses. And yes, concerning the surgery - we initiated Heparin immediately after PD catheter implantation - no incerased bleeding risk observed. Hope it may help.
Dr Strazdins,
Many thanks for your valuable feedback. The information provided is very useful.
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