[Principle and indications for debulking operation in peritoneal carcinosis]

Recent studies demonstrate that cytoreductive surgery (debulking) is a feasible option for the treatment of peritoneal carcinomatosis. Indications for such an approach, often combined with intraperitoneal chemotherapy, are malignant conditions of the appendix, the colon, the ovary and peritoneal mesothelioma. Cytoreduction may also be performed in gastric carcinoma predominantly however in prospectively planned studies. Carcinomas of the hepato-pancreatobiliary system should not be subjected to cytoreduction. The operation itself consists of complete peritonectomy of the parietal peritoneum, multivisceral resection including cholecystectomy, gastric and colonic resection as well as anterior rectal resection. Morbidity and mortality of these procedures are 30% and 1-6% respectively. Depending on the histology of the primary tumor, 5 years survival rates of up to 50-75% can be achieved.