Peritonectomy procedures

Abstract

Treatment of peritoneal surface malignancy requires a combined approach that utilizes peritonectomy procedures and perioperative intraperitoneal chemotherapy. In addition, knowledgeable patient selection is mandatory. The visceral and parietal peritonectomy procedures that one must utilize in an attempt to resect all visible evidence of disease is illustrated below. Complete cytoreduction is essential for treatment of peritoneal surface malignancy to result in long-term survival. All procedures are required in a single surgical event that may require 8-12 hours [1]. The distribution and extent of the malignancy disseminated within the peritoneal space determines the selection of the peritonectomy procedures [2]. Resections are used in the areas of visible cancer progression in an attempt to leave the patient with only microscopic residual disease. In addition to stripping of peritoneal surfaces small tumour nodules on bowel surfaces are removed using electroevaporation. Involvement of visceral peritoneum frequently requires resection of a portion of the stomach, small intestine, or colorectum.