Abstract
Background
The cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal chemotherapy (HIPEC) has become the standard treatment in patients with carcinomatosis peritoneal from different origins. The use of a minimally invasive approach for this high complex procedure might be an alternative that provides them less morbidity and faster recovery with similar oncologic outcomes.
Methods
We describe the initial experience of CRS and HIPEC done via the laparoscopic route in patients with minimal peritoneal metastases in our Unit from March 2016 to January 2018.
Results
A total of eight patients were operated by this minimally invasive approach. The different diagnoses were low-grade pseudomyxoma peritonei (2), benign multicystic mesothelioma (2), primary epithelial ovarian carcinomatosis (2) and locally advanced colon carcinoma T4 (2). The median age was 54 (20–62) years, the median PCI was 3 (2–4), the median operative time was 287 min (240–360), complete cytoreduction CC0 was achieved in all the patients, and no major morbidity was observed. The median length of stay was 4.75 days (4–5). After a median follow-up of 9.5 months, no relapse has been observed.
Conclusion
The results suggest that this minimally invasive approach for CRS and HIPEC is feasible and safe in a highly selected group of patients with peritoneal surface malignancies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Newton AD, Bartlett EK, Karakousis GC (2016) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a review of factors contributing to morbidity and mortality. J Gastrointest Oncol 7(1):99–111
Sommariva A, Zagonel V, Rossi CR (2012) The role of laparoscopy in peritoneal surface malignancies selected for hyperthermic intraperitoneal chemotherapy (HIPEC). Ann Surg Oncol 19:3737–3744
Patriti A, Cavazzoni E, Graziosi L et al (2008) Successful palliation of malignant ascites from peritoneal mesothelioma by laparoscopic intraperitoneal hyperthermic chemotherapy. Surg Laparosc Endosc Percutan Tech 18(4):426–428
Facchiano E, Scaringi S, Kianmanesh R et al (2007) Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of malignant ascites secondary to unresectable peritoneal carcinomatosis from advanced gastric cancer. Eur J Surg Oncol 34:154–158
Muñoz-Casares FC, Rufián S, Arjona-Sánchez Á et al (2011) Neoadjuvant intraperitoneal chemotherapy with paclitaxel for the radical surgical treatment of peritoneal carcinomatosis in ovarian cancer: a prospective pilot study. Cancer Chemother Pharmacol 68:267
Park SY, Choi GS, Park JS, Kim HJ et al (2014) Laparoscopic cytoreductive surgery and early postoperative intraperitoneal chemotherapy for patients with colorectal cancer peritoneal carcinomatosis: initial results from a single center. Surg Endosc 28(5):1555–1562
Esquivel J, Averbach A, Chua TC (2011) Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with limited peritoneal surface malignancies: feasibility, morbidity and outcome in an early experience. Ann Surg 253:764–768
Esquivel J, Averbach A (2012) Laparoscopic cytoreductive surgery and HIPEC in patients with limited pseudomyxoma peritonei of appendiceal origin. Gastroenterol Res Pract 2012:981245
Passot G, Bakrin N, Isaac S, Decullier E, Gilly FN, Glehen O, Cotte E (2013) Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies. Eur J Surg Oncol 40:957–962
Jayakrishnan TT, Zacharias AJ, Sharma A et al (2014) Role of laparoscopy in patients with peritoneal metastases considered for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). World J Surg Oncol 21(12):270
Ferron G, Gesson-Paute A, Classe JM, Querleu D (2005) Feasibility of laparoscopic peritonectomy followed by intra-peritoneal chemohyperthermia: an experimental study. Gynecol Oncol 99:358–361
Facy O, Al Samman S, Magnin G, Ghiringhelli F, Ladoire S, Chauffert B et al (2012) High pressure enhances the effect of hyperthermia in intraperitoneal chemotherapy with oxaliplatin: an experimental study. Ann Surg 256(6):1084–1088
Chua TC, Yan TD, Saxena A, Morris DL (2009) Should the treatment of peritoneal carcinomatosis by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy still be regarded as a highly morbid procedure? A systematic review of morbidity and mortality. Ann Surg 249:900–907
Gouy S, Belghiti J, Uzan C, Canlorbe G, Gauthier T, Morice P (2013) Accuracy and reproducibility of the peritoneal cancer index in advanced ovarian cancer during laparoscopy and laparotomy. Int J Gynecol Cancer 23(9):1699–1703
Garofalo A, Valle M (2009) Laparoscopy in the management of peritoneal carcinomatosis. Cancer J 15(3):190–195
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Supplementary material 1 (MP4 89135 kb)
Rights and permissions
About this article
Cite this article
Arjona-Sanchez, A., Rufian-Peña, S., Sanchez-Hidalgo, J.M. et al. Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy (HIPEC) by Minimally Invasive Approach, an Initial Experience. World J Surg 42, 3120–3124 (2018). https://doi.org/10.1007/s00268-018-4634-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-018-4634-6