HIPEC ERAS

For certain types of cancers that have metastasized within the abdomen and pelvis, the surgeon removes visible tumors and then delivers hyperthermic intraperitoneal chemotherapy (HIPEC), which is heated chemotherapy applied inside your abdominal cavity. HIPEC is used to treat appendiceal cancer and other abdominal cancers.

Our HIPEC ERAS program is designed to help patients return to health more quickly after undergoing the procedure.

Prior To Surgery

• Your surgeon will meet with you to explain surgical plans and set your expectations for surgery.
  • Contact your surgeon via MyChart or call the surgical clinic with questions: 214-645-4673.
• We will call you to provide instructions for surgery and medications prior to surgery. You might also be scheduled for an appointment in our pre-surgical testing clinic to meet with our anesthesia team or have blood drawn.
  • We might request testing from your other physicians.
  • Call our pre-surgical testing clinic with any questions: 214-633-4202.
• Lifestyle modifications:
  • We encourage you to stop smoking and consuming alcohol for one month prior to surgery.
  • We encourage you to increase your physical activity prior to surgery.
  • Eat a balanced, healthy diet, and remain hydrated.
  • Often patients are asked to start a nutritional supplement one to two weeks prior to surgery.
• On the night before surgery, do not eat solid foods after 11 p.m.
• Follow any instructions directly from your surgeon, including chlorhexidine shower and appropriate bowel preparation.
• You are asked to drink 20 ounces of clear liquid carbohydrate drinks (such as Pre-Surgery Ensure Clear, Gatorade G2, or Gatorade) up to two hours before your surgery start time.
• In the pre-operative area, you will receive oral non-narcotic pain medications (acetaminophen, celecoxib, and tramadol) to improve your postoperative pain.
• Our anesthesia pain team also will place an epidural catheter prior to surgery. This is designed to decrease your postoperative pain and need for intravenous (IV) and oral pain medications.

During Surgery

• You will receive general anesthesia and be completely asleep during the procedure.
• Your anesthesia team will monitor you very closely while you are asleep and optimize your condition throughout.
• You are likely to have additional IVs and/or an arterial line placed after you are asleep.
• You will receive multiple medications during surgery to treat pain and nausea.
• There will be a specific and tailored anesthetic protocol to decrease the stress on your body, improve pain control, and accelerate your recovery.

Post-Anesthesia Care Unit (PACU) and After

• Most patients will wake up and spend at least the first night in the intensive care unit (ICU) so that you can be closely monitored.
• As soon as it is safe, the surgery team will ask you to chew gum and ice chips and to drink clear liquids to help with recovery of bowel function.
• You will be given an incentive spirometer to encourage you to take deep breaths.
• Starting on the day of your surgery, we encourage you to get out of bed and walk with help from your nurse and to be in a chair for each meal.
  • Try to increase the distance and frequency of your walks each day; doing so will help your bowel function return to normal, prevent deconditioning, and speed up your recovery.
• Your diet will be advanced as quickly as tolerated following your procedure.
• Pain relieving medication will be given through the epidural, and you will also take scheduled non-opioid pain medications during your recovery and have narcotic medications available for breakthrough pain if necessary.
• Your surgeon will discuss the steps you need to complete to be safely ready for discharge and how quickly that process will occur.
• We believe in working together with patients to have an optimal surgical experience with excellent outcomes.