Role of laparoscopy in patients with peritoneal metastases considered for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) Journal Article

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Authors: Jayakrishnan, T. T.; Zacharias, A. J.; Sharma, A; Pappas, S. G.; Gamblin, T. C.; Turaga, K. K.
Article Title: Role of laparoscopy in patients with peritoneal metastases considered for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC)
Abstract: BACKGROUND: We hypothesized that diagnostic laparoscopy (DL) was feasible for the evaluation of patients with peritoneal carcinomatosis (PC) undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC). METHODS: A retrospective review of PC patients treated from January 2010 to April 2013 was conducted. Data on tumor characteristics, treatment details and survival outcomes were extracted and analyzed. RESULTS: Of the 101 PC patients (mean age 52.9 +/- 14.1 years), 73 diagnostic laparoscopies DL (61 concurrent with CRS + HIPEC) were performed in 70 patients whereas 31 patients underwent direct exploratory laparotomy (EL). Complete laparoscopic assessment was possible in 63 cases (86.3%), resulting in 18 exclusions (27.7%) while 10 cases were converted to open due to inadequate laparoscopic visualization. Subsequently, CRS + HIPEC was performed in 85.4% (of 55 selected for HIPEC, DL) versus 74.2% (EL, P value = 0.20). Among those excluded from HIPEC at the initial operation, delayed HIPEC after conversion chemotherapy was achieved in 6 (of 11 with extensive disease, DL). The incidence of grade 3 to 5 complications was 0% DL versus 10% EL (P value = 0.2). There were no port site recurrences at mean follow up of 9.1 +/- 8 months. CONCLUSIONS: Laparoscopy is a feasible technique for selecting patients with PC for CRS + HIPEC, and can help select patients for conversion chemotherapy in the setting of high peritoneal carcinomatosis index (PCI) score.
Journal Title: World journal of surgical oncology
Volume: 12
ISSN: 1477-7819; 1477-7819
Publisher: Unknown  
Journal Place: England
Date Published: 2014
Start Page: 270
End Page: 7819-12-270
Language: eng
DOI/URL:

10.1186/1477-7819-12-270
Notes: JID: 101170544; 2014/05/13 [received]; 2014/07/20 [accepted]; 2014/08/21 [aheadofprint]; epublish