HIPEC Surgery: New-age treatment for abdominal cancers

Chemotherapy is a common cancer treatment and involves administration of medicines or drugs into the body to destroy the fast-growing cancerous cells. The most advanced surgery to treat cancers in the abdomen is through the Hyperthermic Intraperitoneal Chemotherapy (HIPEC), which has revolutionised the treatment of stomach cancer.

What is HIPEC?

HIPEC is administration of heated chemotherapy in the abdomen through a special machine. This stops the spread of cancer cells in the inner lining of the abdomen called peritoneum – a membrane in the abdominal cavity that connects internal organs.

What type of cancers can be treated with HIPEC?

HIPEC is used to treat cancers which have spread to the peritoneum from the appendix, large intestine (colon & rectum), stomach, ovary or cancers that develop from the peritoneum such as pseudomyxoma peritonei, malignant peritoneal mesothelioma and primary peritoneal cancers.

What is the procedure?

HIPEC surgery is a two-stage procedure. The first includes Cytoreductive Surgery (CRS), which is a major surgical procedure wherein the surgeon removes all visible infections from the peritoneum. The second one is HIPEC which involves administration of heated chemotherapy into the abdomen using a specialised HIPEC machine with strict temperature control. After HIPEC is over, chemotherapy drugs are evacuated and the surgeon closes the incisions.

What are the benefits?

The success of a HIPEC surgery depends on several factors such as stage and type of cancer, patient’s age, overall health and performance status etc. It also depends on the quality of cytoreduction surgery done by an expert surgeon in order to achieve the maximum benefit from HIPEC. The best results are seen in PMP (Pseudomyxoma Peritonei) and Peritoneal Mesothelioma. PMP examination has shown a survival rate of more than 10 years with a well-performed complete CRS and HIPEC. CRS HIPEC has also shown good results in a few patients with gastric cancer, colorectal and ovarian cancer.

What is the recovery time?

CRS HIPEC is a major surgical procedure and most of the patients are hospitalised for around 12-14 days. During the stay, the recovery process is monitored closely to detect any complications. The common complications associated with HIPEC are respiratory, renal, chemotherapy-related, incomplete healing of bowel anastomosis and infections. To reduce these complications, it is advisable to consider HIPEC only at tertiary care hospitals which includes surgeons trained in performing HIPEC, trained teams in anaesthesia, ICU critical care, and medical oncology to manage chemotherapy-related complications, expert radiology and oncopathology teams for correct diagnosis (stage, grade and type of cancer), intervention radiology to help manage post-operative complications, and a rehabilitation team to ensure smooth and early recovery.