Sclerosing Encapsulating Peritonitis Is More Common Following Repeat Hyperthermic Intraperitoneal Chemotherapy

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Sclerosing encapsulating peritonitis (SEP) is a rare but serious complication after cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC).
• Understanding the incidence, risk factors, and clinical characteristics of SEP is crucial for patient management.

Purpose of the Study:

• To determine the incidence and risk factors associated with SEP following CRS +/- HIPEC.
• To characterize the clinical presentation, diagnostic methods, and management outcomes for patients with SEP.

Main Methods:

• Retrospective analysis of patients who underwent CRS with or without HIPEC at a tertiary referral center.
• Comparison of clinical parameters between patients who developed SEP and those who did not.
• Identification of SEP based on clinical, operative, and radiologic findings.

Main Results:

• Six out of 500 patients developed SEP, with a median onset of 5.5 months post-HIPEC.
• SEP was significantly more common in patients undergoing repeat HIPEC procedures (5.7%) compared to initial HIPEC (0.9%).
• Surgical resection of the fibrous rind led to symptom resolution in most treated patients.

Conclusions:

• Sclerosing encapsulating peritonitis (SEP) is a rare complication of HIPEC, typically manifesting within a year as bowel obstruction due to adhesions.
• Repeat CRS/HIPEC procedures are associated with an increased risk of developing SEP.