title: Perioperative fast track program in intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery in advanced ovarian cancer.
abstract: BACKGROUND
  Diffuse peritoneal dissemination in advanced ovarian cancer can be treated using optimal effort surgery involving peritonectomy procedures and the administration of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC).
  
  
  OBJECTIVE
  To report on our experience in the treatment of advanced ovarian cancer using peritonectomy procedures and HIPEC through the fast track program.
  
  
  METHODS
  From September 2008 until May 2010, forty-six patients with primary advanced (stage III-C) or recurrent ovarian cancer have been included in the fast track protocol if they had optimal cytoreduction CC-0 or CC-1 accompanied by HIPEC and there had no more than one digestive anastomosis.
  
  
  RESULTS
  The mean peritoneal cancer index (PCI) was 12.35 (3-21). The median operation time was 380 min (200-540). Optimal surgery CC-0 was achieved in 38 of the 46 patients and CC-1 in the remaining 8. Mean postoperative hospital stay was 6.94 ± 1.56 days (3-11). Major morbidity rates were 15.3%. Paralytic ileus was the most frequent of these. There was no mortality related to the procedure.
  
  
  CONCLUSIONS
  Surgery with peritonectomy procedures and HIPEC in advanced ovarian carcinoma is possible under fast track surgery programs in patients with low volume peritoneal carcinomatosis. Prospective and randomized studies are needed.
authors.affiliation: Department of Surgery, Virgen de la Arrixaca University Hospital, Carretera Madrid-Cartagena s/n, El Palmar, Murcia, Spain.
authors.forename: P A
authors.initials: PA
authors.lastname: Cascales Campos
authors.forename: J
authors.initials: J
authors.lastname: Gil Martínez
authors.forename: P J
authors.initials: PJ
authors.lastname: Galindo Fernández
authors.forename: E
authors.initials: E
authors.lastname: Gil Gómez
authors.forename: I M
authors.initials: IM
authors.lastname: Martínez Frutos
authors.forename: P
authors.initials: P
authors.lastname: Parrilla Paricio
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007422:Intestines / Q000601:surgery; D007432:Intraoperative Period; D008197:Lymph Node Excision; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D010052:Ovariectomy / Q000379:methods; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D013156:Splenectomy; D016896:Treatment Outcome