title: Feasibility of adjuvant laparoscopic hyperthermic intraperitoneal chemotherapy in a short stay setting in patients with colorectal cancer at high risk of peritoneal carcinomatosis.
abstract: BACKGROUND
  Treatment of peritoneal carcinomatosis (PC) of colorectal cancer (CRC) origin is relatively ineffective and associated with morbidity. This raises the question whether we should focus on prevention of the development of PC. We determined the feasibility of adjuvant laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) in a short stay setting.
  
  
  METHODS
  A prospective single centre pilot study was conducted between January 2011 and July 2012. Ten patients at risk of developing PC of CRC origin were included. Laparoscopic HIPEC using Mitomycin-C (90 min; inflow temperature 42-43 °C) was performed within several weeks after primary resection of CRC and was considered feasible when postoperative hospital stay was three days or shorter in at least six patients, and if a maximum of one conversion and one re-admission within 30 days occurred.
  
  
  RESULTS
  HIPEC was performed after a median of 6 weeks (range 3-9 weeks). Postoperatively, five patients were discharged at day one, four patients at day two and one patient at day three. Laparoscopic adhesiolysis resulted in small bowel injury in one patient, but no conversion to open surgery and no postoperative complications were observed. One patient was readmitted within 30 days due to a clostridium infection. The postoperative course was uneventful for the remaining patients.
  
  
  CONCLUSIONS
  Adjuvant laparoscopic HIPEC appeared to be feasible in a short stay setting based on this small pilot study. The necessity of adhesiolysis determines the complexity of the procedure and requires an operating team with experience in minimally invasive abdominal surgery.
authors: Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: D A M
authors: DA
authors: Sloothaak
authors: Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: T J
authors: TJ
authors: Gardenbroek
authors: Department of Radiation Oncology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: J
authors: J
authors: Crezee
authors: Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: W A
authors: WA
authors: Bemelman
authors: Medical Oncology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: C J A
authors: CJ
authors: Punt
authors: Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: C J
authors: CJ
authors: Buskens
authors: Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: p.j.tanis@amc.uva.nl.
authors: P J
authors: PJ
authors: Tanis
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002277:Carcinoma / Q000517:prevention & control* / Q000556:secondary; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007263:Infusions, Parenteral / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D010359:Patient Readmission; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000517:prevention & control* / Q000556:secondary; D010865:Pilot Projects; D011446:Prospective Studies
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin
keywords: Adjuvant; Chemotherapy; Colorectal neoplasms; Laparoscopy; Peritoneal lavage; Peritoneal neoplasms