Preliminary Experience and Morbidity Analysis of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (CRS/H IPEC ) from a Tertiary Cancer Center in India

摘要

Background: Peritoneal carcinomatosis (PC) can arisedirectly from peritoneum (primary) or from regional spread ofgastrointestinal and gynecological malignancies. It is oftenconsidered a terminal event. CRS/HIPEC procedure providesencouraging outcomes in select sub-set of patients with PC.In this study we present our initial experience of this combinedprocedure from a tertiary cancer care center in India.Materials and Methods: Between January 2014 to January2015, 13 patients underwent CRS + HIPEC procedure at ourcenter. Preoperative assessment for cytoreduction was doneusing contrast CT-scan of the abdomen and staging laparoscopy.All procedures were performed by the same surgical team. Aftercytoreduction, HIPEC was performed by closed method.Results: Median patient age was 52 and median PCI was13.5 (5-21). Ovarian cancers were commonest origin of PCin our series. All patients had a complete cytoreduction witha median operative time of 8.3 hours. Postoperative ileus wasthe commonest adverse event. In the immediate postoperativeperiod, major complications were observed in 23% (3/13) of ourpatients (1. intra-abdominal abscess 2. Septicemia and liverfunction derangement 3. Bowel obstruction which required a reoperation. Median hospital stay was 12 days (range 9-45 days)and there was no perioperative mortality.Conclusion: Our initial results indicate that CRS + HIPECprocedure can be performed with acceptable morbidity andno mortality. Appropriate case selection by a multi-disciplinaryteam is vital to achieve complete cytoreduction and optimizeoutcomes.