This is a kind of supra-major surgery for certain cancers of colon, rectum, appendix, ovary, mesothelioma and pseudomyxoma peritonei. These cancers can spread inside the abdominal cavity, leading to tumour deposits on the peritoneum, the inner lining of the abdomen and on the other organs and tissues, known as peritoneal metastases .
In these patients our highly trained and specialized team can perform a surgical procedure known as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) to achieve cure or long-term disease control. During CRS, we aim to remove all visible tumour deposits in the abdominal cavity. This is achieved by a combination of peritonectomy (removal of the lining of the abdominal cavity) and organ resections (removal of parts of or whole organs). The abdominal cavity is then washed for 60-90 minutes with a heated solution containing chemotherapy (HIPEC) to eliminate any microscopic tumour cells circulating in the abdominal cavity.
Traditional chemotherapy is given through the intravenous route to reach the cancer targets. Unfortunately, the disease in peritoneal carcinomatosis often has poor or limited blood supply; therefore, it is more difficult for intravenous chemotherapy to reach these tumors to kill them. HIPEC allows direct contact between the chemotherapy drugs and microscopic cells that remain in the peritoneal cavity.
Though long deemed an experimental procedure, CRS and HIPEC is now a firmly established treatment for patients with the aforementioned cancers. With this procedure, long-term disease control can be achieved, with five year survival rates of at least 45 – 50%.