Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy by laparoscopy via a single-port approach for low-grade peritoneal malignancy

• Published in: Surgical endoscopy Vol. 34; no. 6; pp. 2789 - 2795
• Main Authors: Dumont, F., Duchalais, E., Aumont, A., Thibaudeau, E.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2020; Springer Nature B.V
• Subjects: Abdomen; Abdominal Surgery; Adult; Aged; Cancer; Chemotherapy; Combined Modality Therapy; Cytoreduction Surgical Procedures - methods; Dynamic Manuscript; Endoscopy; Feasibility Studies; Female; Gastric cancer; Gastroenterology; Gynecology; Hepatology; Humans; Hyperthermic Intraperitoneal Chemotherapy - methods; Laparoscopy; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Mesothelioma; Middle Aged; Neoplasm Grading; Operative Time; Patients; Peritoneal Neoplasms - pathology; Peritoneal Neoplasms - therapy; Peritoneum - pathology; Peritoneum - surgery; Postoperative Period; Proctology; Surgery; Single port; Laparoscopy; HIPEC; Cytoreductive surgery
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-020-07492-w

Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a long and complex procedure. A minimal invasive approach is rarely performed. The feasibility of laparoscopic CRS and HIPEC via a single port (SP) approach is unknown. The aim of this study was to assess the feasibility of CRS and HIPEC with a SP approach. Methods This study is IDEAL stage I–IIa. Patients with low grade and limited peritoneal malignancy were included in a tertiary care cancer center. Intra- and post-operative adverse events were recorded and classified according to medical and surgical dedicated classifications. The main objective measurement to assess feasibility was the conversion to open or multiport surgery. Results A total of 12 highly selected patients were assessed. The median operating time was 240 min (range, 180–360) and two near miss events were reported. Two conversions to open and multiport surgery occurred. The median comprehensive complication index was 0 (range, 0–42.6) with two severe adverse events (Clavien–Dindo or CTC-AE ≥ 3). The median length of stay was 8.5 days (range, 5–13). Conclusion CRS and HIPEC via a laparoscopic SP approach are feasible and safe in the short term. The next step should be a prospective development study.