Value of laparoscopy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis. BJS 2013; 100: 285-292.
Published: 2nd November 2012
Authors: L. H. Iversen, P. C. Rasmussen, S. Laurberg
The outcome of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) depends on the extent of peritoneal carcinomatosis. The role of laparoscopy in the preoperative assessment of extent of peritoneal carcinomatosis in potential candidates for cytoreductive surgery and HIPEC was evaluated in a consecutive series.
Patients with peritoneal carcinomatosis from colorectal cancer or appendiceal cancer, pseudomyxoma peritonei or peritoneal mesothelioma referred to a single, national HIPEC centre were included prospectively between June 2006 and January 2012. From September 2010, preoperative evaluation also included a laparoscopy in patients deemed amenable to cytoreductive surgery and HIPEC after radiological evaluation, apart from those with pseudomyxoma peritonei with massive amounts of mucin.
In the period before laparoscopic evaluation, 70 patients underwent laparotomy of whom 39 (56 per cent) completed cytoreductive surgery and HIPEC. After the introduction of laparoscopic assessment, diagnostic laparoscopy was planned in 45 patients and successful in 43. The laparoscopic evaluation excluded 18 patients from surgery because of extensive disease, among other reasons. Laparoscopy was uneventful and associated with no deaths. Twenty‐seven patients were considered amenable to cytoreductive surgery and HIPEC based on laparoscopic findings, of whom 17 completed this treatment; the disease was unresectable in the remaining ten patients. Of 13 patients who were not eligible for laparoscopic evaluation and were subjected to cytoreductive surgery plus HIPEC, 11 completed the procedure. The overall completion rate of cytoreductive surgery and HIPEC increased to 70 per cent (28 of 40) after the introduction of laparoscopic evaluation.
Diagnostic laparoscopy was valuable in preoperative evaluation of the extent of peritoneal carcinomatosis, and improved patient selection for cytoreductive surgery and HIPEC. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.Full text
You may also be interested in
Short‐term medical treatment of hypercalcaemia in primary hyperparathyroidism predicts symptomatic response after parathyroidectomy.
Authors: A. Koman, S. Ohlsson, R. Bränström, Y. Pernow, R. Bränström, I.‐L. Nilsson et al.
Development and evaluation of the General Surgery Objective Structured Assessment of Technical Skill (GOSATS).
Authors: Y. Halwani, A. K. Sachdeva, L. Satterthwaite, S. de Montbrun
Randomized controlled trial of plain English and visual abstracts for disseminating surgical research via social media.
Authors: S. J. Chapman, R. C. Grossman, M. E. B. FitzPatrick, R. R. W. Brady
Authors: H. K. James, A. W. Chapman, G. T. R. Pattison, D. R. Griffin, J. D. Fisher
Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.
Authors: J. H. H. Olsen, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg
Effect of donor nephrectomy time during circulatory‐dead donor kidney retrieval on transplant graft failure.
Authors: L. Heylen, J. Pirenne, U. Samuel, I. Tieken, M. Coemans, M. Naesens et al.
Authors: L. Cairncross, H. A. Snow, D. C. Strauss, M. J. F. Smith, O. Sjokvist, C. Messiou et al.
Dysregulation of the actin scavenging system and inhibition of DNase activity following severe thermal injury.
Authors: R. J. Dinsdale, J. Hazeldine, K. Al Tarrah, P. Hampson, A. Devi, C. Ermogenous et al.
Authors: C. A. Sewalt, E. Venema, E. J. A. Wiegers, F. E. Lecky, S. C. E. Schuit, D. den Hartog et al.
Validation of the Norwegian survival prediction model in trauma (NORMIT) in Swedish trauma populations.
Authors: P. Ghorbani, T. Troëng, O. Brattström, K. G. Ringdal, T. Eken, A. Ekbom et al.