Key factors for best control of the systemic leakage during hyperthermic isolated limb perfusion (HILP) in ECC. A critical synthesis of our experience.

The L-PAM-ILP procedures under true hyperthermal regime (41.5-41.8 degrees C) require both close control of the physical parameters of the treatment (temperatures profiles and time duration, artero-venous pressure, perfusate flow rate) and medical rationale (drug, dosage, fractioning, timing). All the above essential procedures must be supported by rigorous methodology, reliable operation of the medical devices and apparatus and real-time monitoring of the treatment parameters. Real-time monitoring is essential for proper trimming and modulation of the parameters during treatment. This paper delineates the technical improvements that we have implemented for drug leakage monitoring and control in the systemic circulation aimed at improving the therapeutic efficacy and at reducing the occurrence of unexpected complications.

Optimal procedure for thermal delivery in hyperthermic/chemotherapeutic treatments in the isolated perfusion of the the limbs.

Isolated locoregional limbs perfusion treatments of various malignancies have demonstrated synergistic efficacy when hyperthermia was associated with chemotherapy. This paper delineates the criteria, the technical provisions and the specifications that have been improved and implemented at our Institution. It is believed that, following the indications offered in this paper, several, apparently still unsolved problems of treatment planning and implementation will be overcome, offering closely controlled and highly reproducible procedures with a significant progress in the feasibility of reliable comparisons of the results among different research centres and in the reduction of the occurrence of controversial results or unexpected complications.