Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

1. CytoreductiveSurgeryWithHyperthermic IntraperitonealChemotherapy(HIPEC)InDelhi CytoreductiveSurgery WhatiscytoreductivesurgerywithHyperthermic IntraperitonealChemotherapy(HIPEC)? CytoreductivesurgerywithHyperthermicIntraperitonealChemotherapy(HIPEC) is anadvancedprocedureformanagingseveraltypesof cancer.The doctormay performtheprocedureinpatientswithabdominalcancerwhichhavespreadtoand limited totheinnerlining oftheabdomencalledperitoneum. Itoffersseveral advantages to the patients. It helps in delivering the drug at the site of action and improvestheoverallsurvivalrate.Lessamountofdrugissystemicallyabsorbed leadingto fewersystemic side effects. Howshould IknowthatIneedcytoreductive surgery with HyperthermicIntraperitonealChemotherapy(HIPEC)?

2. YourdoctorwillrecommendyoutoundergocytoreductivesurgerywithHIPECifyou aresufferingfromcancersoftheabdominalcavity.Cytoreductivesurgerywith HIPECis usedto metastaticcancers ofthecolon,rectum,ovary andstomach. It is alsousedforthetreatmentofperitonealmesothelioma,pseudomyxomaperitonei andotherdisorders.Itisimportant toaccuratelydiagnosetheperitoneal malignancies. • Whatisthe procedure for performingcytoreductive surgerywithHyperthermic Intraperitoneal Chemotherapy(HIPEC)? • The procedure ofcytoreductivesurgerywithHIPECis oftwo steps.Inthe firststep, the doctorsperformcytoreductivesurgery.Duringthis procedure,theGI • surgeonremovesthevisiblecanceroustissuesandleavesthemicroscopictissues. Apart from the tissues, the surgeon may also remove the organ or part of an organ if itis notpossibletoremovethecanceroustissues.Thedoctormayremoveorgans such asthegallbladder,sectionofthesmallorlargeintestine,andspleen. • ThedoctorthenperformsHyperthermicIntraperitonealChemotherapy (HIPEC)to • remove the microscopic cancerous cells. The surgeon heats the chemotherapeutic drug and delivers them directly into the abdominal cavity through the catheter. The heating temperature is around 42-43°C. The cancerous cells die at 40°C, while the normalhealthy cellsdie at 44°C. • What aretheadvantagesofcytoreductive surgery with HyperthermicIntraperitonealChemotherapy (HIPEC)? • CytoreductivesurgerywithHIPECisanadvancedprocedureforseveraltypesof cancers.ItcombinestheadvantagesofbothcytoreductivesurgeryandHIPEC. • One of thecommon advantages of thissurgeryinclude: • Highdrugpermeation:Thisprocessresultsin high drugpermeationintothecancerous • tissues.Thetechniqueinvolvesthe deliveryofthe chemotherapeuticdrugdirectlyinto the abdominal cavityto achievemaximumefficacy. • Improvementinoverallsurvival:Severalstudieshave been performedon thesurvivalof • patientswith peritonealcancerafter cytoreductivesurgerywithHIPEC. Mostofthestudies indicate thatthistechnique improvesthe overallsurvivalrate.In astudydone on peritoneal

3. metastasesfromcolorectalcancer,themediansurvivalwassignificantlyhigherascompared tosurgeryandchemotherapy,onlysurgery,chemotherapyonly,and bestsupportivecare. • Treatschallengingcancers:CytoreductivesurgerywithHIPEChasgiven hope for patients • sufferingfromcancersthat areverychallengingto manage.Itisimportantto notethatthe cancer tissuesresidingon thesurfaceofthe abdominalorgansorwallsaredifficult to treat withintravenouschemotherapy. • Significantreductionincanceroustissues:CytoreductivesurgerywithHIPECtargetsthe • canceroustissuesthroughdifferentactionsandsignificantlyreduces theoverallcancerous tissues.Itresultsin delayed progression ofcancerinto theadvanced stageand improves survival. • What arethe risks associatedwithcytoreductivesurgery withHyperthermicIntraperitonealChemotherapy (HIPEC)? • ThereareseveralrisksassociatedwithcytoreductivesurgerywithHIPEC.Someof themare: • Clot formation:Patientswith thistechniqueareatincreasedriskfor developing theclotthat • maytraveltovitalorgansand mayleadtolife-threateningcomplications. • Riskof infection:Duetothe exposure ofthe internaltissues,the patientsareatriskfor developinganinfection. • Cardiovascularcomplications:HIPECresultsinraising thetemperature to 40.5°C.Itmay • resultincardiovascularalterationssuchasincreased heartrate,peripheralvasodilation, low cardiacoutput,andreductioninsystemicvascularresistance. • Whichdoctorwill performthecytoreductivesurgery with HyperthermicIntraperitonealChemotherapy(HIPEC)? • InDelhi? • Severaldoctorsperformcytoreductivesurgery with HIPECinDelhi.However,the efficacyand outcomeoftheproceduredependuponseveralfactors,includingthe • experienceofthedoctor,post-procedurecare,andthetypeofmedicalequipment andfacilitiesavailableatthehospital.ThepatientshouldconsultthebestGIsurgeon in DelhiforundergoingcytoreductivesurgerywithHIPEC inDelhi.

4. Arethereoptimumfacilitiesavailableforcytoreductive surgerywithHyperthermicIntraperitoneal Chemotherapy(HIPEC)inDelhi? SeveralhospitalshavethefacilitiesforperformingcytoreductivesurgerywithHIPEC inDelhi.ThebestGIsurgeonsinDelhiareassociatedwithsuper-specialty hospitalsinDelhiforperformingthisprocedure.Youshouldcheckforthefacilities available at thehospitalsinDelhibeforeoptingforthisprocedure. HowmanydaysdoIneedtostay for cytoreductive surgerywithHyperthermic Intraperitoneal Chemotherapy(HIPEC)inDelhi? CytoreductivesurgerywithHIPECinDelhitakesaround8-14hourstocomplete.The patienthadtoremaininthehospitalforaround7-10daysor more,dependingupon the typeofcancer.Thehealthcareteamadvisesthepatienttomaintainabalance betweenrestandactivityasbothareimportant.Whilethepatientmayfeelfatigued forabout2-3months,takingexcessiverestincreasestheriskofbloodclotformation. WhatshouldIdo IfIrequiremoredetailedinformation aboutcytoreductive surgerywithHyperthermic IntraperitonealChemotherapy(HIPEC)inDelhi? Cytoreductivesurgeryisamajorprocedureand isnotforeverypatientwith peritonealmesothelioma.Youmay have several questions toask yourdoctor regardingtheprocedure.Youmayfilltheformtogetyourqueriessolvedbythebest GIsurgeoninDelhi.