Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Techniques

Abstract

Peritoneal carcinomatosis has long been considered a terminal condition and constitutes a difficult therapeutic challenge given the dismal prognosis associated with this entity and the debilitating effect it exerts on affected patients. Over the past decade, novel therapeutic approaches to peritoneal surface malignancies have emerged. These new approaches are all based on a strong rationale: most frequently, peritoneal carcinosis is a locoregional condition that should be approached with locoregional treatments, such as cytoreductive surgery and peritonectomy procedures for macroscopic disease in combination with perioperative intraperitoneal chemotherapy for microscopic residual disease. In order to take advantage of this synergistic effect, different devices and techniques have been developed. Perioperative intraperitoneal chemotherapy is a milestone of the combined approach to peritoneal surface malignancy. Two main modalities for administering chemotherapeutic agents have been described: intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC), and early postoperative normothermic; the former has gained greater acceptance among peritoneal surface malignancy centers.