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Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is associated with improved perioperative outcomes: a single-center early experience propensity-matched analysis

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Abstract

Introduction

The role of laparoscopy in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is not well established. Herein, we describe our early experience of laparoscopic CRS/HIPEC in patients with low-volume peritoneal disease compared to patients who underwent open CRS/HIPEC during the same time period.

Methods

Using a prospectively maintained database, patients who underwent laparoscopic CRS/HIPEC were compared to a control cohort of patients who underwent open CRS/HIPEC, matched for peritoneal carcinomatosis index (PCI), completeness of cytoreduction, and tumor histology.

Results

Between 2008 and 2017, 16 patients underwent laparoscopic CRS/HIPEC and were compared to a matched control cohort of 32 patients who underwent open CRS/HIPEC. Clinical and demographic data were similar between the groups. PCI, number of resected organs, and optimal cytoreduction rates were comparable. Patients who underwent laparoscopic experienced a lower estimated blood loss, (median, [IQR 1–3]); 150 mL, [50–300] vs. 100 mL, [50–125], p = 0.04, shorter length of stay (median [IQR 1–3]; 4 days [3–6] vs. 6 days [5–8], p < 0.01, and a lower 30-day complication rate (6.3% vs. 56.3%, p < 0.01). There was no difference in progression-free survival (p = 0.577) and overall survival (p = 0.472) between the groups.

Conclusions

This preliminary study demonstrates that laparoscopic CRS/HIPEC is feasible and safe for curative treatment in selected patients with low tumor volume. Minimally invasive CRS/HIPEC is associated with fewer postoperative complications and shorter length of stay. There was no difference in long-term oncological outcomes between the groups.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Division of Surgical Oncology Division, Department of Surgery, Icahn School of Medicine at Mount Sinai Medical Center, E. 98th Street. Suite 7A, Box 1103, New York, NY, 10029, USA

    Tali Shaltiel, Daniel Solomon, Eric R. Pletcher, Benjamin J. Golas, Deepa R. Magge, Umut Sarpel, Daniel M. Labow & Noah A. Cohen

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  1. Tali Shaltiel
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Drs. Tali Shaltiel, Daniel Solomon, Eric R. Pletcher, Benjamin J. Golas, Deepa R. Magge, Umut Sarpel, Daniel M. Labow, and Noah A. Cohen have no conflict of interest or financial ties to disclose.

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Shaltiel, T., Solomon, D., Pletcher, E.R. et al. Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is associated with improved perioperative outcomes: a single-center early experience propensity-matched analysis. Surg Endosc 36, 6153–6161 (2022). https://doi.org/10.1007/s00464-022-09034-y

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