PERITONEOECTOMY IN COMBINATION WITH INTRA-ABDOMINAL HYPERTHERMIC CHEMOPERFUSION

S. I.  Kirkilevsky; A. A.  Mashukov; V. E.  Maksimovsky; A. I.  Tkachenko; R. R.  Yarema; V. V.  Lisachenko; V. V.  Pirogov

doi:10.31640/JVD.3.2019(3)

S. I. Kirkilevsky National Cancer Institute (Kiev)
A. A. Mashukov Odessa National Medical University
V. E. Maksimovsky Odessa National Medical University
A. I. Tkachenko Odessa National Medical University
R. R. Yarema Lviv Oncological Regional Treatment and Diagnostic Center
V. V. Lisachenko Odessa National Medical University
V. V. Pirogov Odessa National Medical University

DOI: https://doi.org/10.31640/JVD.3.2019(3)

Keywords: hyperthermicintra peritoneal chemotherapy; gastric cancer; cytoreductive surgery; peritoneal dissemination; carcinomatosis; peritoneoectomy.

Abstract

Treatment of late stages of the tumor process requires the implementation of increasingly high-tech and complex interventions, aimed at improving the overall and disease-free survival, improving the quality of life of patients. HIPEC technique is a point of growth at which progress in oncology and all medical science can be demonstrated. Among the specialists involved in the implementation of this type of specialized care, there is still no consensus on what traits the malignant process of the peritoneum should be able to use this technique. Intraperitoneal hyperthermic perfusion (HIPEC) is gaining popularity as a method of palliative treatment of patients with common tumors of the abdominal cavity. Using the popular medical virtual search engine PubMed identified 2140 cited publications on the search query "hipec, peritoneal" and 752 cited publications "hipec, peritoneal, CRS", finally the phrase "hipec, cancer, randomized trial" with the clarifying characteristic "Clinical Trial" (excludes review articles) – 30 scientific publications, 10 of them in the last 5 years. All this demonstrates the growing interest to HIPEC around the world. The technique is used mainly for ovarian cancer, mesothelioma, pseudomyxoma of the peritoneum, colorectal cancer, and gastric cancer. It is possible as a combination of surgically performed PE and HIPEC, and HIPEC in mono-mode, in the absence of macroscopically detected carcinoma of the abdominal cavity, but positive washings from the peritoneum in verified cancer. It is performed both during the cytoreductive operation and as the second stage as a component of the Second look procedure, as well as in the adjuvant mode in the absence of carcinomatosis, but of high potential danger of peritoneal dissemination (for example, if the tumor has infiltrated the entire wall of the organ). HIPEC has never become a standard treatment, and multicenter randomized trials are regularly conducted on this topic.

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