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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of pseudomyxoma peritonei: A single-center experience

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background and Aims

Pseudomyxoma peritonei (PMP) results from perforated appendiceal tumors. It is usually diagnosed preoperatively by imaging. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), although aggressive long procedure with high complications rate, was considered the optimal treatment. This study is aiming to study the role of CRS and HIPEC in the management of PMP and assess the outcome.

Methods

This is a retrospective study which was conducted at King Faisal Hospital and Research Center, a tertiary care hospital during the period from November 2008 to June 2016. Approval of the Research Advisory Council was obtained. Forty-one procedures of CRS and HIPEC were performed in 38 patients. Using the open abdomen technique, CRS was performed using standard peritonectomy procedures and visceral resections directed toward the complete elimination of tumors from abdominopelvic cavity. HIPEC was performed using mitomycin C in a dose of 30 mg/m2 and allowed to circulate in abdominopelvic cavity for 90 min at 41.0 to 42.2 °C.

Results

Forty-one procedures were performed in 38 patients. Three procedures were done as repeat CRS and HIPEC. No perioperative mortality. Cystoscopy and bilateral ureteric stents in 35 procedures (85.5%). Hospital stay (range 9–85 days) average is 21 days. Follow up period is 1–84 months, and median follow up is 54 months. Five-year survival rate is 92%. Median 5-year disease-free survival rate is 60%. Two patients died during the follow up period by septic shock and one patient died from disease progression.

Conclusion

CRS and HIPEC is well-tolerated and feasible management for PMP.

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Author information

Authors and Affiliations

  1. General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Ayman Zaki Azzam

  2. Surgical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Ayman Zaki Azzam & Tarek Mahmoud Amin

  3. General Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Zyad Adil Alyahya & Ahmed Abbas Al Wusaibie

Authors
  1. Ayman Zaki Azzam
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  2. Zyad Adil Alyahya
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  3. Ahmed Abbas Al Wusaibie
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  4. Tarek Mahmoud Amin
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Correspondence to Ayman Zaki Azzam.

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Conflict of interest

AZA, ZAA, AAAl-W, and TMA declare that they have no conflict of interest.

Ethics statement

The study was approved by the institute’s ethics review board and is in compliance with the Helsinki Declaration, 1964, and its subsequent modifications. Written informed consent was obtained from all patients who underwent treatment. Since this was a retrospective study, formal consent for participation in this study was not obtained.

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Azzam, A.Z., Alyahya, Z.A., Wusaibie, A.A.A. et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of pseudomyxoma peritonei: A single-center experience. Indian J Gastroenterol 36, 452–458 (2017). https://doi.org/10.1007/s12664-017-0799-4

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  • DOI: https://doi.org/10.1007/s12664-017-0799-4

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