Laparoscopic HIPEC for Peritoneal Carcinomatosis from Gastric Cancer -   Technique and Early Outcomes of Our First Cases

Bălescu, Irina; Godoroja, Daniela; Gongu, Mircea; Tomulescu, Victor; Copăescu, C

doi:10.21614/chirurgia.112.6.714

Cited by 7 publications

(12 citation statements)

References 28 publications

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“…Already in 2008, Gesson-Paute et al [23] indicated the enhanced tissue uptake of oxaliplatin hat was observed in an animal study comparing the pharmacokinetics between open surgery and laparoscopy in pigs. Similar results are confirmed by Petrillo et al [24] in a prospective human study where a higher peritoneal absorption of cisplatin is reported in the minimal invasive arm when compared to the open surgery [25].…”

Section: Discussionsupporting

confidence: 83%

Is minimal invasive surgical treatment of ovarian cancer plus HIPEC a utopia? A review of the literature

2021

EJGO

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The purpose of this study is to evaluate the effectiveness and safety of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) approached by minimally invasive surgical (MIS) techniques. We conducted a systematic review of the published relevant studies and evaluated a total of 403 patients, with a median age of 57 years old (20-69). The histology of the patients included 160 (39.7%) patients with pseudomyxoma peritonei, 43 (10.6%) with mesothelioma peritonei, 37 (9.2%) with epithelial ovarian cancer (EOC), 80 (19.8%) with appendiceal cancer and 26 (6.4%) with colon cancer, while the histology of the rest of the patients was not specified in the studies. The median Periotoneal Cancer Index (PCI) was 4 (1-10) and complete cytoreduction (R0) was achieved in 239 patients (60%). 145 (36%) of the patients underwent omentectomy, 37 patients (9.2%) underwent cecum/right colectomy, 41 patients (10.1%) underwent salpingovariectomy, 6 (1.5%) small bowel resection, 28 (6.7%) peritonectomies, in 9 (2.2%) sigmoeidectomy and 107 (26.5%) appendectomy, with a mean operative time of 240 min (90-510). Conversion to laparotomywas performed in 13 (3.2%) cases, while in 32 (7.9%) an intestinal anastomosis or suture was required. The median length of stay was 4.5 days (3-6) and the median follow-up of the patients was 13.5 months (1-72). We concluded that minimal invasive surgery can be considered as an approach in the application of hyperthermic intraperitoneal chemotherapy. Further large studies with higher quality data are warranted to verify our findings.

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Section: Discussionsupporting

confidence: 83%

Is minimal invasive surgical treatment of ovarian cancer plus HIPEC a utopia? A review of the literature

2021

EJGO

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“…No other study was identified after reviewing the reference list. Therefore, 19 studies were included in the analysis [14,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Eight studies had a casecontrol design with open-CRS-HIPEC, four of which had a retrospective design [25,27,29,32], and the remaining were prospective studies [14,28,31,33].…”

Section: Study Identificationmentioning

confidence: 99%

“…Only two studies reported blood transfusion during the perioperative time [14,32]. Lap-CRS-HIPEC was performed using a median of 5 trocars placed at a variable quadrant of the abdominal wall in 13 studies [14,[17][18][19][20][22][23][24][25][26][27]31,34]. Two studies reported using a single port [21,29], while one described a hand-assisted technique [33].…”

Section: Intraoperative Datamentioning

confidence: 99%

“…Two hundred forty-seven visceral resections were described (113 omentectomies, 32 colectomies, 20 salpingo-oophorectomies, ten small bowel resections, seven recto-sigmoidectomies, four partial gastrectomies, 13 hysterosalpingooophorectomies). In nine studies, the administration of HIPEC was performed throughout the trocars [14,[17][18][19][20]23,27,33,34]. All the other studies used the same trocar access but removed the devices before introducing the HIPEC catheters.…”

Section: Intraoperative Datamentioning

confidence: 99%

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Laparoscopic Cytoreduction Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Peritoneal Surface Malignancies (PSM): Italian PSM Oncoteam Evidence and Literature Review

Sommariva

Valle

Gelmini

et al. 2022

Cancers

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Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained increasing acceptance in clinical practice. Performing CRS and HIPEC laparoscopically represents a challenging and intriguing technical evolution. However, the experiences are limited, and the evidence is low. This retrospective analysis was performed on patients treated with laparoscopic CRS-HIPEC within the Italian Peritoneal Surface Malignancies Oncoteam. Clinical, perioperative, and follow-up data were extracted and collected on prospectively maintained databases. We added a systematic review according to the PRISMA method for English-language articles through April 2022 using the keywords laparoscopic, hyperthermic, HIPEC, and chemotherapy. From 2016 to 2022, fourteen patients were treated with Lap-CRS-HIPEC with curative intent within the Italian centers. No conversion to open was observed. The median duration of surgery was 487.5 min. The median Peritoneal Cancer Index (PCI) was 3, and complete cytoreduction was achieved in all patients. Two patients (14.3%) had major postoperative complications, one requiring reintervention. After a median follow-up of 16.9 months, eleven patients were alive without disease (78.6%), two patients developed recurrence (14.3%), and one patient died for unrelated causes (7.1%). The literature review confirmed these results. In conclusion, current evidence shows that Lap-CRS-HIPEC is feasible, safe, and associated with a favorable outcome in selected patients. An accurate patient selection will continue to be paramount in choosing this treatment.

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“…On the other hand, there have been fewer reports about the efficacy of laparoscopic HIPEC (L-HIPEC): in a report by Yonemura et al, L-HIPEC combined with intraperitoneal chemotherapy could decrease PCI index before cytoreductive procedures [22] . In another report by Baslescu el al., they used laparoscopy for the cytoreductive surgery (L-CRS) and L-HIPEC) to emphasize the advantages of minimal invasive surgery and contributed to improved postoperative outcomes [23] . Nevertheless, the role of HIPEC in the neoadjuvant setting has not been investigated in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant Laparoscopic HIPEC combined with Neoadjuvant Chemotherapy followed by Surgery plus intraoperative HIPEC for Advanced Gastric Cancer at risk of Peritoneal Carcinomatosis: feasibility and safety assessment from retrospective case control study

Beeharry

Liu

et al. 2020

Preprint

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Objective: In this study we have retrospectively evaluated the feasibility and safety of a novel therapeutic regimen for the management of Advanced Gastric Cancer (AGC) at risk for peritoneal carcinomatosis (PC) involving neoadjuvant laparoscopic hyperthermic intraperitoneal chemotherapy (NLHIPEC) and neoadjuvant chemotherapy (NAC).Methods: From December 2017 to June 2018, 7 AGC patients undergoing NLHIPEC + NAC + Surgery+ Intraoperative HIPEC + adjuvant chemotherapy (AC) were included in the study and observed for associated complication and morbidity. AGC patients undergoing other neoadjuvant and prophylactic treatment approaches were retrospectively analyzed and case-matched. Intraoperative and post-operative events, clinical recovery and morbidity were closely monitored till 1 month after the last cycle of chemotherapy.Results: Of a total of 328 AGC patients undergoing curative surgery, 7 other patients undergoing NAC + HIPEC, 7 patients undergoing surgery + HIPEC and 17 patients undergoing NAC were retrospectively included. There was no 30-day post-operative mortality recorded in the 4 groups. In total, 14 events were recorded and 5/14 of the complications were rated as Clavien I; 8/14 patients were classified as Clavien II and 1/14 patient was recorded as Clavien grade IIIa. There was no grade IIIb-V event. The results suggest that the proposed treatment regimen is safe and feasible.Conclusions: This combination of NLHIPEC and NAC in the management of AGC at high risk for peritoneal involvement is feasible, safe, well-tolerated and worth exploring.

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Laparoscopic HIPEC for Peritoneal Carcinomatosis from Gastric Cancer - Technique and Early Outcomes of Our First Cases

Cited by 7 publications

References 28 publications

Is minimal invasive surgical treatment of ovarian cancer plus HIPEC a utopia? A review of the literature

Is minimal invasive surgical treatment of ovarian cancer plus HIPEC a utopia? A review of the literature

Laparoscopic Cytoreduction Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Peritoneal Surface Malignancies (PSM): Italian PSM Oncoteam Evidence and Literature Review

Neoadjuvant Laparoscopic HIPEC combined with Neoadjuvant Chemotherapy followed by Surgery plus intraoperative HIPEC for Advanced Gastric Cancer at risk of Peritoneal Carcinomatosis: feasibility and safety assessment from retrospective case control study

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