Effects of postoperative intraperitoneal chemotherapy on peritoneal wound healing and adhesion formation
Cancer arising in the abdomen or pelvis may spread to peritoneal surfaces in the absence of lymphatic or hematogenous metastases. This is a localized disease process that is generally thought to have a universally lethal outcome. To treat isolated cancer spread on peritoneal surfaces, extensive surgery and intraperitoneal chemotherapy have been combined. This cytoreductive approach has been described as a potential successful tool in the management of a variety of malignancies that disseminate primarily in the abdomen and pelvis . The surgical procedures for complete cytoreduction vary with the extent and anatomic location of the carcinomatosis or Sarcomatosis but always include stripping away parietal peritoneal surfaces and resection of visceral peritoneal surfaces involved by tumor . Peritonectomy procedures result in an extensive absence of serosal coverage of the abdomen and pelvis. This trauma causes serosal damage, which initiates an inflammatory response and a wound healing process that can lead to fibrin deposition and intraabdominal adhesion formation. The intent of this chapter is to provide an overview of wound healing and adhesion formation mechanisms in the peritoneal cavity. The effect of postoperative intraperitoneal chemotherapy on these processes will be then discussed.
KeywordsAdhesion Formation Intraperitoneal Chemotherapy Postoperative Adhesion Malignant Peritoneal Mesothelioma Abdominal Adhesion
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