title: Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies.
abstract: BACKGROUND
  Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are considered the only curative treatment for many peritoneal surface malignancies. The purpose of this study was to evaluate feasibility and safety of CRS combined with HIPEC by laparoscopy for patients with limited peritoneal disease and to compare postoperative outcomes with those for an open procedure.
  
  
  METHODS
  Between January 2011 and November 2012, all patients with low-grade pseudomyxoma peritonei (PMP) or multicystic mesothelioma (MM) and limited peritoneal disease (Peritoneal Cancer Index [PCI] less than 10) underwent CRS and HIPEC by a laparoscopic approach. The study cohort was matched with a historical cohort of patients with the same characteristics (completeness of cytoreduction, HIPEC agent, PCI ± 11 and age ± 20 years) treated with CRS and HIPEC by laparotomy.
  
  
  RESULTS
  Eight patients (five low-grade PMP and three MM) treated by a laparoscopic approach were compared to eight patients treated by laparotomy. All patients underwent complete cytoreductive surgery with HIPEC, and no conversion to laparotomy was needed. The median surgical length was 210 min (150-300) vs 240 (210-360), with a median hospital stay of 12 days (9-18) vs 19 (13-33). One patient had a postoperative complication (intraperitoneal haematoma treated by radiological drainage) vs four in the laparotomy group.
  
  
  CONCLUSIONS
  Laparoscopic CRS combined with HIPEC is feasible and safe for curative treatment of strictly selected patients with peritoneal surface malignancy and might reduce postoperative complications and length of hospital stay.
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Passot
authors.affiliation: UMR 37-38 Université Lyon 1, Lyon, France; Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Gynecology Department, France.
authors.forename: N
authors.initials: N
authors.lastname: Bakrin
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Pathology, France.
authors.forename: S
authors.initials: S
authors.lastname: Isaac
authors.affiliation: Hospices Civils de Lyon, Pole IMER, Lyon, France; Health Information and Clinical Research, France.
authors.forename: E
authors.initials: E
authors.lastname: Decullier
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France.
authors.forename: F N
authors.initials: FN
authors.lastname: Gilly
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France. Electronic address: olivier.glehen@chu-lyon.fr.
authors.forename: O
authors.initials: O
authors.lastname: Glehen
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Cotte
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D006979:Hyperthermia, Induced; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010529:Peritoneal Cavity; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011184:Postoperative Period; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies
keywords: HIPEC; Laparoscopic; Peritoneal carcinomatosis