Peritonectomy procedures for peritoneal surface malignancies: PSOGI-ESGO-ISSPP Lyon consensus

The nomenclature and execution of peritonectomy procedures for peritoneal surface malignancies significantly vary between surgeons and centres. The aim of this consensus was to reach uniform nomenclature for peritonectomy procedures, to define subregions of each peritonectomy procedure, and to define boundaries of each subregion.

The modified Delphi technique was employed. A group of experts elaborated on the initial classification of six peritonectomy procedures. They added newer and ancillary peritonectomy procedures and defined boundaries of each procedure. Then a panel of surgeons with expertise in cytoreductive surgery voted on questions in two rounds. Consensus was reached if an option received >75% of the votes.

Of 112 surgeons invited, 107 (95.5%) and 101 (90.1%) voted in round I and round II respectively. Consensus was reached on 207 of 211 questions (98.1%), including all of the questions related to the subdivisions of peritonectomy procedures and the boundaries of each peritonectomy procedure. The four questions on which consensus was not reached were related to the 'most appropriate term' for specific peritonectomy procedures. A reporting form was devised to document the extent of peritonectomy.

This consensus successfully devised a revised nomenclature for peritonectomy procedures. The reporting format is an important tool for research on the extent of peritoneal resection required for treatment of peritoneal surface malignancies.