Peritonectomy Surgery for Mesothelioma Patients

Peritonectomy Surgery for Mesothelioma | Abdomen Cancer

Peritonectomy is a specialized surgical procedure designed to address cancers that originate within the abdomen. It involves the meticulous removal of either the entire or a portion of the abdominal lining, medically known as the peritoneum, along with any associated tumors. This surgical intervention serves as a crucial component of cytoreductive surgery (CRS), with the primary objective of reducing the tumor burden within the patient’s body.

In the context of peritoneal mesothelioma, peritonectomy frequently precedes a significant adjunctive treatment called heated intraperitoneal chemotherapy (HIPEC). Together, peritonectomy and HIPEC represent the foremost standard of care for peritoneal mesothelioma.

What is Peritonectomy?

Peritonectomy encompasses the surgical removal of the abdominal lining, which houses the peritoneum, along with any malignant tumors attached to it. This procedure plays a pivotal role in the treatment of several abdominal cancers, including peritoneal mesothelioma, by effectively reducing the volume of tumor tissue within the patient’s body.

The Vital Role of HIPEC

After undergoing peritonectomy, patients typically proceed to receive HIPEC therapy. HIPEC, short for heated intraperitoneal chemotherapy, involves the introduction of a heated chemotherapy solution into the abdominal cavity. This specialized treatment aims to eradicate any residual cancer cells that may remain following the peritonectomy. The elevated temperature of the chemotherapy solution, combined with its confined administration within the abdominal region, enhances the effectiveness of the chemotherapy drugs in targeting and eliminating cancer cells.

The Peritonectomy Procedure

Patients embarking on a peritonectomy journey should be well-informed about what to anticipate during the procedure and throughout their recovery:

Preparation: Prior to the surgery, patients receive comprehensive instructions from their medical care team regarding necessary preparations. These typically include a period of fasting, often around 24 hours before the surgery. Additionally, patients may undergo a thorough pre-admission workup, involving blood tests, imaging scans, and consultations with various specialists. This comprehensive evaluation ensures that patients are adequately prepared for the surgery and increases the chances of a successful outcome.

Procedure Steps: While specific details of the peritonectomy procedure may vary among surgeons and medical facilities, certain fundamental steps remain consistent:

  1. The surgeon makes a precise incision in the abdominal region.
  2. Specialized surgical instruments are employed to delicately remove the affected sections of the abdominal lining.
  3. When necessary, the surgeon may also remove portions of other affected tissues, such as the stomach or intestines.
  4. HIPEC may be administered to cleanse the abdominal cavity, either before or after repairing any affected tissues.
  5. The surgical incision is meticulously closed, and the patient is carefully transferred to the recovery area.

Duration: A peritonectomy procedure, coupled with HIPEC, can be a substantial undertaking, lasting anywhere from 6 to 14 hours. The medical team ensures that patients and their loved ones are well-informed about the various aspects of the procedure and are readily available to address any questions or concerns patients may have concerning peritonectomy for mesothelioma.

Post-Peritonectomy Recovery

Recovery following a peritonectomy with HIPEC can vary based on individual factors. Typically, patients spend several weeks in the hospital, followed by several months of recuperation in the comfort of their homes.

Benefits of Peritonectomy + HIPEC

Peritonectomy combined with HIPEC offers numerous advantages for individuals battling peritoneal mesothelioma, including:

  1. Enhanced Survival Rates: Patients treated with peritonectomy and HIPEC often experience superior survival rates compared to those treated with chemotherapy alone.
  2. Reduction in Tumor Volume: Peritonectomy effectively eliminates mesothelioma tumors, allowing HIPEC to operate more effectively with a diminished cancer load.
  3. Improved Quality of Life: Multiple studies suggest that peritonectomy and HIPEC can enhance the overall quality of life for patients confronting abdominal cancers.

Experts estimate that the inclusion of peritonectomy and HIPEC extends the survival rate for peritoneal mesothelioma from approximately one year, without these treatments, to approximately seven years. Patients contemplating this treatment approach are strongly encouraged to engage in comprehensive discussions with their healthcare providers to gain insight into how this strategy may personally benefit them.

Side Effects and Risks of Peritonectomy + HIPEC

As with all medical procedures, peritonectomy and HIPEC carry inherent risks and the potential for specific side effects. These may encompass bleeding, blood clots, and other complications typically associated with surgical interventions. Patients are encouraged to maintain open communication with their medical care teams to promptly identify and address any potential side effects.

Common side effects associated with mesothelioma peritonectomy with HIPEC may include:

  • Formation of abscesses
  • Blood clot formation
  • Digestive issues
  • Fistula formation, which denotes abnormal connections between body parts or tissues
  • Fatigue
  • Infections
  • Profuse bleeding
  • Tissue perforation, indicating the formation of a hole
  • Non-healing wounds, known as dehiscence

While bleeding and infection are among the most frequently encountered side effects, research suggests that peritonectomy and HIPEC are associated with a lower incidence of side effects compared to other common surgical procedures. Patients should diligently monitor for any side effects as instructed by their medical care teams. It is imperative to recognize that, for many eligible patients, the benefits of peritonectomy and HIPEC substantially outweigh the associated risks.