European Journal of Surgical Oncology. 2006 Apr 19; [Epub ahead of print] Accepted 2 March 2006. Available online 21 April 2006. [Link]
A. Garofaloa, M. Valleb, J. Garciac and P.H. Sugarbakerc
aGeneral–Oncological Surgery, Department of Surgery, S. Camillo Hospital, Rome, Italy
bLaparoscopic Unit, Department of Surgery, S. Camillo Hospital, Rome, Italy
cProgram in Peritoneal Surface Malignancy, Washington Cancer Institute, 106 Irving Street, NW, Suite 3900, Washington, DC 20010, USA
Aim: To report the use of laparoscopic Intraperitoneal Hyperthermic Chemotherapy (LIPHC) in the treatment of malignant ascites.
Methods: From September 2001 to December 2003, 14 patients between the age of 56 and 78 years were treated. Ascites was from gastric cancer (5 cases), colorectal cancer (3 cases), ovarian cancer (3 cases), breast cancer (2 cases) and peritoneal mesothelioma (1 case). The LIPHC was carried out at 42 degrees C for 90min with 1.5% dextrose solution as a carrier. Chemotherapy was cisplatin and doxorubicin or mitomycin depending on the type of primary tumor. The drains were left in situ after surgery and removed when perfuse drainage ceased.
Results: Ascites was controlled in all the treated cases. A CT scan performed in follow-up showed a small, clinically undetectable, fluid accumulation in the pelvis of one patient.
Conclusions: This method resulted in benefit for those peritoneal carcinomatosis patients with debilitating malignant ascites who were excluded from cytoreductive surgery. Proficiency in laparoscopic staging procedures and experience in the management of carcinomatosis and intraperitoneal hyperthermic chemotherapy (IPHC) are required for the success of the procedure.