engleski

Total peritonectomy procedure with hyperthermic intraoperative intraperitoneal chemotherapy administration: single-centre case series analysis and literature review.

Background and objectives: Peritoneal carcinosis has been considered a lethal clinical entity for a long time. Cytoreductive surgery with intraperitoneal hyperthermic chemoperfusion is an aggressive treatment option for these patients with this diagnosis. Although promising, this therapeutic regimen has been associated with significant morbidity, prolonged hospital stay and an increased risk for perioperative mortality. Purpose of this article is to give an overview of a strategy for this major oncological surgical procedure and to share results from our centre. Materials and methods: Data were retrospectively collected from all patients with peritoneal carcinomatosis treated by means of peritonectomy and hyperthermic intraoperative intraperitoneal chemotherapy between October 2008 and December 2010 at the University Hospital Merkur, Zagreb, Croatia. Results: A total of 18 patients (7 male, 11 female) were treated with this procedure, mean age of patients being 52 (range 32-63 years). Primary tumours were pseudomyxoma peritonei (1 patient), colorectal cancer (8 patients), gastric cancer (1 patient), ovarian cancer (6 patients) and mesothelioma (2 patients). Complete cytoreduction has been performed in 17 of 18 patients (94.4%). Postoperative mortality, within the first month was 16.6%. The cause of death was sepsis and septic complications all due to anastomotic insufficiencies. At 2-year follow-up overall survival was estimated to be 83.8% and the disease-free 5-year survival rate 44.5%. Conclusion: With proper patient selection, good perioperative preparation, optimal anaesthetic and surgical technique we can achieve satisfactory survival rate. However, further studies are needed to determine modifiable risk factors that contribute to postoperative mortality.

Peritoneal surface malignancies, Peritoneal carcinomatosis, Cytoreductive surgery, Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC)

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