Nerve-preserving Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Advanced Primary Caecal...

Radical surgery to achieve optimal cytoreduction in locally advanced caecal cancer may dictate femoral or sciatic nerve resection, especially in cases with pelvic side-wall involvement. In such a situation, gait disturbance is inevitable. A 61-year male with a new-onset right leg limping due to locally advanced right colon carcinoma underwent cytoreductive surgery (CRS) with partial resection of right pelvic side- wall, and hyperthermic intraperitoneal chemotherapy (HIPEC). During the operation, we aimed to preserve both the sciatic and femoral nerves to prevent further deterioration of his right leg limping postoperatively. However, we did not compromise the principles of radical surgery and all tumoral implants around femoral vessels and nerves were removed. Completeness of cytoreduction score was zero (CC0). The resection of all macroscopic disease is the main goal of CRS, but as seen in our case with tumor-related walking difficulty, nerve-sparing CRS and HIPEC may prevent further deterioration of the situation. Key Words: Cytoreductive surgery, Hyperthermic intraperitoneal chemotherapy, Sciatic nerve, Femoral nerve, Caecal cancer.