Review Article

Technical aspects of cytoreductive surgery†

  1. Shigeki Kusamura MD, PhD1,
  2. Sarah T. O'Dwyer MD, FRCS2,
  3. Dario Baratti MD1,
  4. Rami Younan MD3,
  5. Marcello Deraco MD1,*

Article first published online: 22 AUG 2008

DOI: 10.1002/jso.21058

Issue

Journal of Surgical Oncology

Journal of Surgical Oncology

Special Issue: Dedicated to the 5th International Consensus Meeting on Peritoneal Surface Malignancies Treatment

Volume 98, Issue 4, pages 232–236, 15 September 2008

Additional Information

How to Cite

Kusamura, S., O'Dwyer, S. T., Baratti, D., Younan, R. and Deraco, M. (2008), Technical aspects of cytoreductive surgery. Journal of Surgical Oncology, 98: 232–236. doi: 10.1002/jso.21058

Author Information

  1. 1

    Department of Surgery, National Cancer Institute of Milan, Milan, Italy

  2. 2

    Peritoneal Tumour Service, Christie Hospital, Manchester, UK

  3. 3

    Department of Surgery, Surgical Oncology Unit, CHUM, University of Montreal health centre, Montreal, Canada

*Istituto Nazionale Tumori Milano, Via Venezian 1, 20133 Milan, Italy; Fax: +39-02-23902404.

  1. †

    The authors have no financial interest related to the contents of this article to disclose.

Publication History

  1. Issue published online: 22 AUG 2008
  2. Article first published online: 22 AUG 2008
  3. Manuscript Accepted: 21 MAR 2008
  4. Manuscript Received: 19 MAR 2008

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Keywords:

  • peritoneal carcinomatosis;
  • cytoreductive surgery;
  • consensus

Abstract

At the Fifth International Workshop on Peritoneal Surface Malignancy, in Milan, the consensus on technical aspects of cytoreductive surgery (CRS) for peritoneal surface malignancy was obtained through the Delphi process. Five conflicting points were discussed: radicality of the peritonectomy procedure, cytoreduction of neoplastic nodules <2.5 mm, the timing of bowel anastomoses in relation to hyperthermic intraperitoneal chemotherapy (HIPEC) and indications of protective ostomies. According to the panel of experts a partial parietal peritonectomy restricted to the macroscopically involved regions could be indicated in all listed clinical conditions with the exception of peritoneal mesothelioma. No expert was of the opinion that a radical parietal peritonectomy is advisable irrespective of the disease being treated. All the experts agreed that electrovaporization of small (<2.5 mm) non-infiltrating metastatic nodules in the mesentery would be appropriate, even if theoretically the HIPEC affords microscopic cytoreduction. The panel also agreed that in the closed technique for HIPEC administration the intestinal anastomoses should be fashioned after completion of the perfusion. Finally when considering the place for protective ostomies the experts voted for a flexible approach allowing the surgeon to exercise discretion for individual patients. J. Surg. Oncol. 2008;98:232–236. © 2008 Wiley-Liss, Inc.

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