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Title: | A minimally invasive approach for peritonectomy procedures and hyperthermic intraperitoneal chemotherapy (HIPEC) in limited peritoneal carcinomatosis: The American Society of Peritoneal Surface Malignancies (ASPSM) multi-institution analysis | Authors: | Arjona-Sanchez, A. Esquivel, J. Glehen, O. Passot, G. Turaga, K. K. Labow, D. Rufian-Pena, S. Morales, R. VAN DER SPEETEN, Kurt |
Issue Date: | 2019 | Publisher: | SPRINGER | Source: | SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 33(3), p. 854-860 | Abstract: | Background Minimally invasive surgery is playing an increasing role in the treatment of patients with gastrointestinal and gynaecological malignancies as the data show reduced morbidity, faster recovery and similar oncological outcome when compared to open procedures.Materials and methodsThe American Society of Peritoneal Surface Malignancies (ASPSM) conducted a retrospective study to analyse peritonectomy procedures and HIPEC done via the laparoscopic route. A database with standard clinical and pathological parameters was set up and distributed amongst ASPSM members. Rate of relapse, morbidity and mortality were the primary endpoints of the study.ResultsA total of 90 patients from 7 centres around the world were identified. Sixty percent were female. Mean age was 50years. Peritoneal carcinomatosis from appendiceal origin was the most common diagnosis in a 64.9% of patients and colon origin was diagnosed in 16.5% of patients. Mean peritoneal cancer index (PCI) was 4.1 (0-10). Forty-one percent of patients had a bowel resection. Mean operative time was 4.7h (2.5-8). All patients had a complete cytoreduction and HIPEC. Grade 3 and 4 morbidity was 3.0 and 6.5%, respectively. The most common reason for re-operation was an internal hernia in 2 out of 5 cases. Operative mortality and re-admission rates were 0 and 5%, respectively. Mean hospital stay was 7.4days (1-18). At a mean follow-up of 31.6months, 15/90 patients have a disease relapse but loco-regional relapse was identified in only five patients.ConclusionsAnalysis of these data suggests that minimally invasive approach for peritonectomy procedures and HIPEC is feasible, safe and should be considered as part of the armamentarium for highly selected patients with peritoneal surface malignancies with limited tumour burden, defined as PCI of 10 or less and borderline tumours as low-grade pseudomyxoma and benign multicystic mesothelioma. | Notes: | [Arjona-Sanchez, A.; Rufian-Pena, S.] Univ Hosp Reina Sofia, Dept Surg, Unit Surg Oncol, Cordoba, Spain. [Arjona-Sanchez, A.; Rufian-Pena, S.] Univ Hosp Reina Sofia, IMIBIC, CIBERehd, Cordoba, Spain. [Esquivel, J.] Frederick Mem Hosp, Dept Surg Oncol, 7211 Bank Court,Suite 200, Frederick, MD USA. [Glehen, O.; Passot, G.] Ctr Hosp Lyon Sud, Dept Surg Oncol, Pierre Benite, France. [Turaga, K. K.] Univ Chicago Med, Sect Gen Surg & Surg Oncol, Chicago, IL USA. [Labow, D.] Mt Sinai Med Ctr, Dept Surg, Div Surg Oncol, Box 1259, New York, NY 10029 USA. [Morales, R.] Hosp Son Spaces, Unit Surg Oncol, Palma De Mallorca, Spain. [van der Speeten, K.] Hasselt Univ, Dept Med & Life Sci, Hasselt, Belgium. | Keywords: | Hyperthermic intraperitoneal chemotherapy (HIPEC); Cytoreductive surgery (CRS); Laparoscopic surgery;Hyperthermic intraperitoneal chemotherapy (HIPEC); Cytoreductive surgery (CRS); Laparoscopic surgery | Document URI: | http://hdl.handle.net/1942/29039 | ISSN: | 0930-2794 | e-ISSN: | 1432-2218 | DOI: | 10.1007/s00464-018-6352-4 | ISI #: | 000459683700024 | Rights: | Springer Science+Business Media, LLC, part of Springer Nature 2018 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2020 |
Appears in Collections: | Research publications |
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