Minimally invasive surgery uses small cuts and a camera to guide the surgeon through an operation. This procedure is often used in other abdominal issues like gallbladder surgery. But, medical professionals have recently performed it on patients with peritoneal mesothelioma.

The Current Standard of Care for Peritoneal Mesothelioma

Patients suffering from peritoneal mesothelioma have to have major open surgery to remove as much of the visible tumor from the peritoneal lining as possible. The procedure is cytoreduction. Then, because mesothelioma grows as a series of small tumors that spread out, hyperthermic intraperitoneal chemotherapy (HIPEC) follows the cytoreductive surgery. This heated chemotherapy cocktail is then applied into the abdomen so the drugs can kill off any cancerous cells that were too small for the surgeon to see.

In order for patients to be eligible for this procedure, they have to be in good health. That means no health problems due to the potential blood-loss or complications and infections associated with major surgeries. In fact, the combination of cytoreductive surgery and HIPEC is so risky that some experts are not convinced that the risks outweigh the benefits of the procedure.

Minimally Invasive Surgery

Minimally invasive surgeries are also called laparoscopic procedures. The new study by the American Society of Peritoneal Surface Malignancies into laparoscopic procedures was published in the journal Surgical Endoscopy. It examined the effectiveness of laparoscopic procedures for treating patients with tumors in their peritoneum, or the lining of the abdomen-where peritoneal mesothelioma begins to grow.

The patients who participated in the study all underwent a minimally invasive cytoreduction surgery, followed up with HIPEC.

No patients died during the procedure, and only 5% of them were readmitted after the procedure for hernias. The patients stay in the hospital for an average of 7 days after they had the surgery and HIPEC, unlike patients who undergo the more traditional major open form of cytoreductive surgery.

When the researchers followed-up with the patients 31 months after the laparoscopic procedure, they discovered that only 15 of the 90 patients had a relapse of their peritoneal cancer. Of those 15 only five of those individuals developed a new tumor where the original one formed.

Researchers felt confident enough with the new procedure to write that a “minimally invasive approach for peritonectomy procedures and HIPEC is feasible, safe and should be considered as part of the armamentarium [treatment options].”

What This Means for Peritoneal Mesothelioma Patients

The laparoscopic procedure cannot be performed on everyone. Patients will only be eligible if the tumors are small enough to score a 10 or less on the peritoneal cancer index (PCI).

But, there is a higher chance that patients who would have otherwise been denied the major open surgery due to their poor health will be able to undergo a laparoscopic procedure. This is because laparoscopic procedures are less dangerous and patients are less likely to experience complications.

Recovery times are shorter for minimally invasive procedures. Patients will be able to get back to enjoying a greater quality of life sooner than they would have had they required a major open surgery.

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Sources
  1. Tufts Medical Center. "Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC)." Retrieved from: https://www.tuftsmedicalcenter.org/-/media/Brochures/TuftsMC/Patient-Care-Services/Departments-and-Services/Cancer-Center/HIPEC_Final.ashx?la=en&hash=49ECD33312242DC03D3DA5722A6C25C80E5B46A6. Accessed August 16, 2018.

Last modified: September 1, 2018