Cytoreduction with HIPEC (Heated Intraoperative Peritoneal Chemotherapy) surgery is used to treat cancers that have spread to the abdomen of patients with peritoneal mesothelioma (often referred to as abdominal mesothelioma). This procedure is an option for both early and advanced stages of peritoneal mesothelioma.
It is suitable for patients who are otherwise in good health.The treatment requires 2 steps. First, the tumor is removed. Next, doctors circulate a heated chemotherapeutic solution straight to the site of the cancer for a maximum of 2 hours. This new technique helps reduce or even eliminate the side effects typically associated with oral or intravenously (IV) administered chemotherapy.
Cytoreduction with HIPEC: Step by Step
Once the patient is under general anesthesia, the surgeon makes a long incision down the middle of the abdomen. Then, the surgeon removes the cancerous part of the abdominal lining and carefully examines the abdomen, as well as the surrounding organs, and removes any visible tumors.
Because it can be very time-consuming for the surgeon to do a thorough examination of all the organs, this procedure can take 10–12 hours. Once this cytoreduction phase of the operation is completed, the second phase—the HIPEC—begins. Here, the surgeon delivers a bath of heated chemotherapy solution directly into the abdomen.
This combination of heat and chemotherapy is believed to be effective, because the liquid can flow into tiny crevices to reach and kill more cancer cells than can be seen with the naked eye. The goal is for the HIPEC to help destroy any remaining cancer cells and all remaining tumors.
Because of the length and complexity of this operation, the recovery process can be long. Patients should plan to spend at least 2 weeks in the hospital following the procedure.
After the Surgery: Returning Home
Once the happy day arrives when a patient can be discharged from the hospital, the medical team will provide specific home care instructions. These instructions are unique to each patient, but will include a list of medications, instructions for what to eat and how to manage pain, and referrals for physical and occupational therapy.