Cytoreductive surgery and HIPEC is a treatment option for people who have advanced surface spread of cancer within the abdomen. When it’s paired with HIPEC, it considerably increases life expectancy and reduces the rate of cancer recurrence.
What is Cytoreductive Surgery?
The surgical management of advanced ovarian, primary peritoneal, colorectal and gastric cancers has evolved from the performance of basic debulking procedures to the incorporation of more comprehensive surgical procedures. This surgery aims for the complete removal of all visible tumors affecting the protective lining of the abdomen. Cytoreduction is complex and can last for an extended period of time, and only an experienced specialist can perform the procedure effectively.
During cytoreductive surgery, the surgeon uses a tool called an electrosurgical handpiece to remove tumors. It generates an intense amount of heat via high-voltage electricity and burns diseased tissue at the edges of the incision.These complex procedures involving multi-organ resections are generally long and require excellent knowledge of abdominal anatomy.
What is HIPEC?
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery.
Unlike systemic chemotherapy delivery, which circulates throughout the body, HIPEC delivers chemotherapy directly to cancer cells in the abdomen. This allows for higher doses of chemotherapy treatment. Heating the solution may also improve the absorption of chemotherapy drugs by tumors and destroy microscopic cancer cells that remain in the abdomen after surgery.
How does it work?
Before patients receive HIPEC treatment, doctors perform cytoreductive surgery to remove visible tumors within the abdomen. Cytoreductive surgery is accomplished using various surgical techniques. Once as many tumors as possible have been removed, the heated, sterilized chemotherapy solution is delivered to the abdomen to penetrate and destroy remaining cancer cells. The solution is 41 to 42 degrees Celsius, about the temperature of a warm bath. It’s circulated throughout the abdomen for approximately 1 ½ hours. The solution is then drained from the abdomen and the incision is closed.
After the procedure, patients are required spend an average of 2 weeks in the hospital. Nurses monitor vital signs throughout the patient’s stay and make sure that no post-surgical complications occur.
Advantages
Allows for high doses of chemotherapy
Enhances and concentrates chemotherapy within the abdomen
Minimizes the rest of the body’s exposure to the chemotherapy
Improves chemotherapy absorption and susceptibility of cancer cells
Reduces chemotherapy side effects
Consultant,
Department of Surgical Oncology,
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