Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of malignant ascites secondary to unresectable peritoneal carcinomatosis from advanced gastric cancer.
OBJECTIVE
To review our experience of laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of malignant ascites from advanced gastric cancer in order to discuss benefits, problems and possible indications.


METHODS
From June 2000 to May 2003 laparoscopic approach was used to perform HIPEC on five patients affected by malignant ascites secondary to unresectable peritoneal carcinomatosis of gastric origin, in order to associate the benefits of a definitive palliation of ascites with a minimal invasiveness. All patients had ascites related symptoms requiring iterative paracenteses. Intraperitoneal perfusion of mitomycin-C and cisplatin was delivered for 60-90min with an inflow temperature of 45 degrees C.


RESULTS
Complete clinical regression of ascites and related symptoms was achieved in all the five patients treated. Intraoperative course was uneventful in all cases. Mean operative time was 181min. No postoperative deaths, related to the procedure, occurred. Only a case of delayed gastric empting was recorded as a minor postoperative complication.


CONCLUSIONS
Laparoscopic HIPEC appears to be a safe and effective procedure to treat debilitating malignant ascites from unresectable peritoneal carcinomatosis.
Facchiano
E
E
Department of Surgery, Louis Mourier Hospital, Assistance Publique, Hopitaux de Paris, University Paris VII, 178 rue des Renouillers, 92701 Colombes Cedex, France.
Scaringi
S
S
Kianmanesh
R
R
Sabate
J M
JM
Castel
B
B
Flamant
Y
Y
Coffin
B
B
Msika
S
S
D000328:Adult; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D002277:Carcinoma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome