Description:
Peritoneal metastases commonly result from the regional spread of gastrointestinal, gynaecological and other malignancies. Peritoneal carcinomatosis is an advanced form of cancer associated with short survival and poor quality of life, which may lead to bowel obstruction, ascites and pain.
This procedure was developed by Paul Sugarbaker at the Washington Cancer Institute. A laparotomy is performed under general anaesthesia and all gross tumour is removed along with the involved organs, peritoneum and tissue. The surgery includes:
· removal of the right hemicolon, spleen, gall bladder, parts of the stomach, greater omentum and lesser omentum
· stripping of the peritoneum from the pelvis and diaphragm
· stripping of tumour from the surface of the liver
· removal of the uterus and ovaries in women
· removal of the rectum in some cases.
The aim of the surgery is to remove all macroscopic tumour, although residual tumour is sometimes left behind.
After the organs have been removed, the abdomen is perfused with fluid containing a chemotherapy agent, heated to between 40 and 48°C. The fluid is perfused for 60 to 120 minutes and then drained from the abdomen, before the laparotomy is closed. A further course of systemic or intraperitoneal chemotherapy may be administered after the surgery.
|
