Complete laparoscopic pelvic peritonectomy plus hyperthermic intraperitoneal chemotherapy

• Published in: Techniques in coloproctology Vol. 24; no. 10; pp. 1083 - 1088
• Main Authors: Arjona-Sánchez, A., Cortés-Guiral, D., Duran-Martínez, M., Villarejo-Campos, P., Sánchez-Hidalgo, J. M., Casado-Adam, A., Rodriguez-Ortiz, L., Romero-Ruiz, A., Rufian-Andujar, B., Espinosa-Redondo, E., Valenzuela-Molina, F., Rufián-Peña, S., Briceño-Delgado, J.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-10-2020; Springer Nature B.V
• Subjects: Abdominal Surgery; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy; Colorectal cancer; Colorectal Surgery; Combined Modality Therapy; Female; Gastric cancer; Gastroenterology; Humans; Hyperthermia, Induced; Hyperthermic Intraperitoneal Chemotherapy; Laparoscopy; Medicine; Medicine & Public Health; Mortality; Multimedia Article; Neoplasm Recurrence, Local; Ovarian cancer; Proctology; Spain; Surgery; Surgical techniques; Spain; Laparoscopy; Peritonectomy procedure; HIPEC; Peritoneal carcinomatosis
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-020-02277-8

Background
The aim of our study was to present the technique for, and early results of complete laparoscopic pelvic peritonectomy (LPP) plus hyperthermic intraperitoneal chemotherapy (HIPEC).
Methods
We conducted a study on consecutive patients who had LPP for limited peritoneal carcinomatosis (peritoneal carcinomatosis index < 10) from ovarian cancer, colon cancer and benign multicystic mesothelioma, from January 2017 to November 2019 at 2 referral centers in Spain. Perioperative, pathologic, 30-day major morbidity and mortality characteristics were analyzed. The surgical technique is shown in the attached video.
Results
Twelve LPP + HIPEC were performed. Complete cytoreduction was achieved in 100% of the patients, the median duration of the operation was 450 min (range 360–600 min). There were 2 cases (16%) of IIIa morbidity (trocar hernia and pleural effusion), and no mortality. The median length of hospital stay was 5.5 days (range 4–10 days). The median length of follow-up was 10 months (range 2–30 months). There was a recurrence at the splenic hilum in 1 patient which was treated by laparoscopic splenectomy and one nodal recurrence at 13 months while all other patients are alive and free of disease at last follow-up.
Conclusions
This is the first technical video of a minimally invasive approach for complete pelvic peritonectomy plus omentectomy associated with HIPEC. For highly selected patients, this procedure presents a feasible and safe alternative to the maximally invasive approach.