Total Mesenteric Peritonectomy for Peritoneal Metastases (with video)

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Complete cytoreductive surgery (CRS) is the only potentially curative treatment for peritoneal metastases (PM).
• Diffuse mesenteric PM often contraindicates CRS.
• A standardized total mesenteric peritonectomy technique is presented.

Observation:

• A patient with urachal adenocarcinoma and diffuse mucinous PM underwent induction chemotherapy with significant regression.
• The patient then received CRS, including a total parietal and mesenteric peritonectomy.
• A completeness of cytoreduction score of 1 was achieved.

Findings:

• Total mesenteric peritonectomy was safely performed in a patient with diffuse mesenteric PM.
• The patient remained disease-free at 6-month follow-up.
• The technique is applicable even with widespread mesenteric PM.

Implications:

• This standardized technique expands the applicability of CRS for patients with diffuse mesenteric PM.
• Total mesenteric peritonectomy offers a therapeutic option for previously untreatable cases.
• Further research may validate this approach for similar patient cohorts.