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Published on: July 31, 2016
Perioperative fast track program in intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) after
P A Cascales Campos1, J Gil Martínez, P J Galindo Fernández
1Department of Surgery, Virgen de la Arrixaca University Hospital, Carretera Madrid-Cartagena s/n, El Palmar, Murcia, Spain.
Introduction:
Diffuse peritoneal dissemination in advanced ovarian cancer can be treated using optimal effort surgery involving peritonectomy procedures and the administration of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC).
Objective:
To report on our experience in the treatment of advanced ovarian cancer using peritonectomy procedures and HIPEC through the fast track program.
Patients And Method:
From September 2008 until May 2010, forty-six patients with primary advanced (stage III-C) or recurrent ovarian cancer have been included in the fast track protocol if they had optimal cytoreduction CC-0 or CC-1 accompanied by HIPEC and there had no more than one digestive anastomosis.
Results:
The mean peritoneal cancer index (PCI) was 12.35 (3-21). The median operation time was 380 min (200-540). Optimal surgery CC-0 was achieved in 38 of the 46 patients and CC-1 in the remaining 8. Mean postoperative hospital stay was 6.94 ± 1.56 days (3-11). Major morbidity rates were 15.3%. Paralytic ileus was the most frequent of these. There was no mortality related to the procedure.
Conclusion:
Surgery with peritonectomy procedures and HIPEC in advanced ovarian carcinoma is possible under fast track surgery programs in patients with low volume peritoneal carcinomatosis. Prospective and randomized studies are needed.
