Erschienen in:
31.01.2018 | Gastrointestinal Oncology
Techniques for Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy
verfasst von:
Rebecca M. Dodson, MD, Michael Kuncewitch, MD, Konstantinos I. Votanopoulos, MD, PhD, Perry Shen, MD, Edward A. Levine, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 8/2018
Einloggen, um Zugang zu erhalten
Excerpt
Peritoneal ‘carcinomatosis’ or peritoneal metastasis is associated with abdominal distention, pain, early satiety, malnutrition, ascites, cachexia, and bowel obstruction. Nearly 50% of patients with appendiceal malignancy, 10% of patients with colon cancer, and 5% with rectal cancer will develop peritoneal surface malignancy (PSM).
1–3 Despite significant advances in palliative systemic chemotherapy, it has less efficacy for peritoneal carcinomatosis compared with solid organ metastasis. Cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) has been used to treat peritoneal carcinomatosis from a variety of primaries, including the appendix, stomach, small bowel, ovary, mesothelium, colon, and rectum. For select patients, HIPEC provides an opportunity for long-term survival, control of tumor burden, and improvement of symptoms not achievable with other therapies; however, HIPEC has high morbidity (minor 20%, major 20%) and mortality (1–5%).
4–7 …
