CYTOREDUCTIVE SURGERY

Cytoreductive surgery is a surgical procedure that aims to reduce the number of cancer cells in the abdominal cavity for patients with tumors that have spread intraabdominally. It is often used to treat ovarial cancer but can also be used for other abdominal malignancies

Side Effects From This Form of Treatment

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 CRS-HIPC is a major operation that may involve the resection of abdominal organs. As expected, it carries a considerable postoperative (within 30 days from the surgery) morbidity of 12-56 percent and a mortality of 0-12 percent.

These complications can be grouped into three categories:

  • Intra-abdominal complications: Intra-abdominal gastrointestinal leak, abscess, and fistula complicate about 15% of cases of CRS-HIPEC. This is increased with the number of bowel resections and anastomosis.

  • Abdominal wall morbidity: This category includes wound infection, abscess, and dehiscence/evisceration of about 15%. This is a consequence of impaired wound healing from the application of the HIPEC and potential CRS involving resection of abdominal wall deposits.

  • Systemic complications: These are related to the systemic effect of the absorbed peritoneal chemotherapy and include bone marrow suppression, sepsis, and pulmonary complications.

The Role of the Laparoscopic Approach:
In general, CRS-HIPEC requires complete exploration of the abdominal cavity and potentially multiple resections of abdominal viscera, rendering the laparoscopic approach of limited value besides initial exploration. However, in the selected group of patients with minimal CRS or for second-look surgery and prophylactic HIPEC, laparoscopic HIPEC can be performed.
The benefit of such an approach is based on avoiding the big abdominal incision and complications (about 15 percent). In addition, laparoscopy is traditionally associated with less postoperative pain, shorter hospital stay, and earlier return to work activity.
It should be emphasized that, though feasible for a selected group of patients, its role and application are not yet reported. Therefore, at UMGCCC we offer the laparoscopic approach for a selected subgroup of patients, while open CRS-HIPEC remains our standard technique.

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FAQs

CRS is short for cytoreductive surgery. It is simply the removal of all sites of cancer within the abdominal cavity. However, the operation itself is not simple and should only be performed by experts with many years of experience.

There are numerous reports showing that this procedure may be dangerous and risky. With our years of experience, we have performed this procedure safely with zero mortality.

Most of our patients have a hospital stay of approximately 7-10 days. In some cases, the hospitalization could be shorter or possibly longer. For all of our patients, our expectation is that they will return home after surgery being able to complete their normal daily home activities.