Pseudomyxoma peritonei surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Surgery
- Most commonly, treatment for pseudomyxoma peritonei involves surgery.
- A more aggressive approach by Sugarbaker utilizes peritonectomy and visceral resections, called cytoreductive surgery (CRS), in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) that is featured by direct targeting of the microscopic disease, locoregional drug availability, minimal systemic exposure and improved drug penetration through hyperthermia.
- When appropriate, surgery may include intraperitoneal hyperthermic chemotherapy, or post operative systemic chemotherapy.
- In situations where surgery is not required immediately, patients can be monitored via CT scans, tumor marker laboratory tests, and physical symptoms, to determined when, and if, surgery is warranted.
- Although some surgical procedures may be rather extensive, patients can and do recover from surgery, and the majority of these patients can and do live productive lives.
- In debulking, the surgeon attempts to remove as much tumor as possible, while cytoreductive surgery involves surgical removal of the peritoneum and any adjacent organs which appear to have tumor seeding.
Since the mucus tends to pool at the bottom of the abdominal cavity, it is common to remove the ovaries, fallopian tubes, uterus, and parts of the large intestine.
- Depending upon the spread of the tumor, other organs might be removed, including but not limited to the gallbladder, spleen, and all or portions of the small intestine and/or stomach.
- For organs that cannot be removed safely (like the liver), the surgeon strips off the tumor from the surface. [1]
References
- ↑ Harmon R, Sugarbaker P (2005). "Prognostic indicators in peritoneal carcinomatosis from gastrointestinal cancer". Int Semin Surg Oncol. 2 (1): 3. PMID 15701175.