Background: Laparoscopic peritonectomy has been described as a feasible and reproducible technique, however it is technically challenging and requires specific training, Our aim is to present our experience on laparoscopicperitonectomy and laparoscopic HIPEC in a newly stablish center. Materials and Methods: A retrospective analysis from march 2019 to June2021 from the King Khaled Hospital (Najran, Saudi Arabia) HIPEC data base has been conducted forevery patient who underwent complete laparoscopic cytoreductive surgery with HIPEC. An exhaustive registry was made of all clinical relevant data, surgical procedure, outcome criteria as overall survival and adverse events according to (CTCAE) version4.0. All procedures were done by well-trained surgeon. Results: Excluding cases converted to open due to adhesions, 5 patients were analyzed, 3 of them were female. Median age was 43 years. PM were from appendix, colorectal and ovarian cancer for 3, 1, and 1 patient respectively. Median PCI was 8 (3-18) and median time of surgery (excluding HIPEC time) was 8 hours(4.5-10.5). Hospital median length of stay was 8 days (only one patient was admitted for 2 days in ICU).All patients underwent resection of the primary tumor, parietal peritonectomy and one of them total pelvic peritonectomy plus salpingo-oophorectomy with histerectomy and extraction of the specimen through the vagina, 2 patient underwent bowel resection with anastomosis.Three patients had complications, grade IV (hemoperitoneum), grade III (intestinal obstruction), grade II (port side hernia).One patient died from covid-19 disease with severe pneumonia two month after surgery. The other 4 patients are alive without recurrence after a medianfollow-up of 8 months. Conclusions: Total laparoscopic peritonectomy and laparoscopic HIPEC is feasible and safe, with shorter LOHS and the same or lower rate of complications compared to open CRS and the same oncologic results. In experienced centers it seems reasonable to offer our patients all the benefits of minimally invasive surgery.
Initial experience in laparoscopic peritonectomy and Hipec for the treatment of peritoneal metastasis in a newly establish center