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Laparoscopic cytoreductive surgery and HIPEC: a comparative matched analysis
L Rodríguez-Ortiz1, A Arjona-Sánchez2, M Ibañez-Rubio1
1Unit of Surgical Oncology, University Hospital Reina Sofia, Menéndez Pidal Av., Córdoba, Spain.
Surgical Endoscopy
|April 25, 2020
Summary
Laparoscopic cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) is safe for selected patients with limited peritoneal disease. This approach offers shorter hospital stays and quicker return to chemotherapy compared to open surgery, with similar oncological outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) shows promise for peritoneal metastases (PM) but has high morbidity.
- Laparoscopy is increasingly used in oncologic surgery, with evaluated benefits for CRS+HIPEC in selected patients.
Purpose of the Study:
- To analyze the feasibility and outcomes of using laparoscopy for CRS+HIPEC in patients with limited peritoneal disease.
Main Methods:
- Retrospective study of 825 patients with PM from a prospective database (January 2009-July 2019).
- Comparison of laparoscopic CRS+HIPEC (L-CRS-HIPEC) with a matched cohort of open CRS+HIPEC (O-CRS-HIPEC) patients.
Main Results:
- Homogeneous preoperative and intraoperative features between L-CRS-HIPEC (n=18) and O-CRS-HIPEC (n=42) groups.
- Shorter hospital stays (4 vs. 9 days) and faster return to chemotherapy (4 vs. 8 weeks) in the L-CRS-HIPEC group.
- No significant differences in perioperative transfusion, surgery time, or morbi-mortality; no early locoregional relapse in the L-CRS-HIPEC group.
Conclusions:
- Laparoscopic CRS+HIPEC is feasible and safe in highly selected patients with limited PM.
- Laparoscopic approach leads to shorter hospital stays and earlier return to adjuvant chemotherapy.
- Further research is needed to confirm the benefits of minimally invasive procedures for PM management.
