Cytoreductive Surgery, Heated & Pressurized Aerosol Chemotherapy
Cytoreductive Surgery (CRS) combined with HIPEC (Hyperthermic Intraperitoneal Chemotherapy) or PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) represent advanced, combined-modality treatment protocols for selected stage-IV abdominal malignancies and peritoneal carcinomatosis.
These procedures deliver highly concentrated chemotherapy directly within the abdominal cavity to destroy microscopic cancer cells while minimizing systemic side effects.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is performed immediately following surgical tumor debulking (Cytoreductive Surgery - CRS). After removing all visible tumors, a highly concentrated, heated chemotherapy solution (41°C to 42°C) is circulated continuously throughout the abdominal cavity for 60 to 90 minutes. The thermal heat physically sensitizes cancer cells, enhancing drug penetration to destroy microscopic cancer residues.
PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) is a innovative, minimally-invasive procedure for patients with advanced peritoneal cancers who may not be immediate candidates for major open surgeries. Under laparoscopic guidance, chemotherapy is converted into a micro-droplet aerosol and sprayed under pressure inside the abdomen. The pressure forces the aerosolized drug deep into tissues, providing high clinical efficacy with minimal systemic side effects.
These advanced procedures are primary indicators for:
Cytoreductive Surgery with HIPEC is a major operation requiring expert post-operative management. Patients typically stay in our dedicated oncology ICU for 2 to 3 days to balance fluid levels and optimize organ functions, with transition to progressive nutrition and full mobilization facilitating discharge within 10 to 14 days. PIPAC, being minimally invasive, allows discharge in just 2 to 3 days.
Generally no. Because the heated chemotherapy in HIPEC is delivered directly inside the abdominal cavity, very little of the drug enters the bloodstream. This localized delivery minimizes systemic side effects, avoiding severe hair loss, extreme nausea, and deep fatigue commonly associated with standard chemotherapy.
The PCI is a standardized clinical scoring system (from 0 to 39) used to quantify the extent of cancer spread across 13 abdominal regions. Calculating a precise PCI score helps Dr. Parveen Mendiratta determine surgical feasibility and optimize the success rate of cytoreductive surgeries.