Techniques in Coloproctology

, Volume 21, Issue 6, pp 479–480 | Cite as

The use of carbon dioxide insufflation to facilitate identification of intestinal injuries in patients undergoing cytoreductive surgery and intraperitoneal chemotherapy

  • M. A. Kozman
  • O. M. Fisher
  • S. J. Valle
  • N. Alzahrani
  • D. L. MorrisEmail author
Trick of the Trade

Since Sugarbaker introduced the concept of cytoreduction (CRS) and intraperitoneal chemotherapy (IPC) in the mid 1990s, the approach to management of peritoneal metastases has drastically changed [1]. This has resulted in markedly improved outcomes for selected patients with peritoneal dissemination of many tumours including colorectal cancer and pseudomyxoma peritonei [2, 3]. The treatment necessitates radical surgical resection of macroscopically visible disease in the abdomen and pelvis and administration of intraperitoneal chemotherapy to eradicate remaining microscopic disease [4]. However, this surgical procedure harbours a level of complexity in that it combines long operative times, numerous and complex resections, peritoneal stripping and administration of heated intraperitoneal chemotherapy, all of which contribute to a degree of morbidity and mortality. Intestinal perforations, anastomotic leaks and their subsequent clinical sequelae (such as fistulae and abscesses) are...


Author contributions

MAK, OMF, SJV, NA, DLM contributed to conception and design. All authors helped in drafting and revising of article content and final approval of manuscript prior to submission.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (MP4 63251 kb)


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • M. A. Kozman
    • 1
  • O. M. Fisher
    • 1
    • 2
  • S. J. Valle
    • 1
  • N. Alzahrani
    • 1
    • 3
  • D. L. Morris
    • 1
    Email author
  1. 1.Hepatobiliary and Surgical Oncology Unit, Department of SurgerySt George Hospital, University of New South Wales, Research and Education CentreSydneyAustralia
  2. 2.School of MedicineUniversity of Notre DameSydneyAustralia
  3. 3.College of MedicineAl-Imam Mohammad Ibn Saud Ismalic UniversityRiyadhSaudi Arabia

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