title: [Significance of peritonectomy for peritonitis carcinomatosis].
abstract: We analyzed patients who underwent multimodal treatment with peritonectomy as an aggressive treatment for peritonitis carcinomatosis. Peritonectomy was treated in eighteen cases (eleven gastric cancer, seven colon cancer). Out of these eighteen cases, nine were initial operation, six were recurrence after first operation and three were for relief after palliative operation for peritoneal dissemination. Five cases of recurrence included ileus. Of all eighteen patients, ten had received preoperative chemotherapies. Peritonectomy made complete resection possible principle, and the procedure included resection of the primary lesion, subtotal colectomy and peritonectomy. An intestinal stoma was needed in nine cases, consequently. All patients cases underwent continuous hyperthermic peritoneal perfusion (CHPP). Early postoperative peritoneal chemotherapy was given in five cases. By peritonectomy for a first time operation, macroscopically complete resection was possible in six cases. In relief and recurrence cases few tumor cells remained in five cases. Ileus due to peritoneal carcinomatosia was eliminated in all cases, and caloric intake became possible. Fourteen cases had postoperative complication (morbidity 78%), and treatment-related death occurred in three cases (mortality 17%). It became possible to resect even the peritoneal dissemination that was inoperable by conventional surgery, and improvement of QOL was achieved by peritonectomy in cases of carcinomatous peritonitis. However, postoperative care is important since aggression becomes more intense.
authors.affiliation: Dept. of Surgery, Tsuruga National Hospital.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kinoshita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Sawa
authors.forename: Masako
authors.initials: M
authors.lastname: Fujioka
authors.forename: Seiichi
authors.initials: S
authors.lastname: Taguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuyama
authors.forename: Syouichi
authors.initials: S
authors.lastname: Okada
authors.forename: Sotohiro
authors.initials: S
authors.lastname: Yoshimitsu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D010537:Peritoneum / Q000601:surgery*; D010538:Peritonitis / Q000188:drug therapy / Q000601:surgery*; D012086:Reoperation