Peritonectomy Results at St.George Hospital, Sydney, Australia at 677 Procedures

Abstract

Background: Peritonectomy is now widely used in the world with a with a good evidence base in PMP, appendiceal adenocarcinoma(PMCA), colorectal cancer (CRC), mesothelioma and recurrent ovarian cancer. We began peritonectomy at our institution in 1995. Methods: We analysed our 677 cases from a prospective database. Results: 553 patients underwent 677 procedures. 83% of patients received heated intraperitoneal chemotherapy (HIPEC) and 46% early post operative intraperitoneal chemotherapy (EPIC). Mean operative time was 9 hours (SD 3.2), mean length of stay was 29 days (SD 26.7) including 4 days in ICU (SD 7.4) and 4 days in HDU (SD 4.6). Mean transfusion requirement included 0.5 units of platelets (SD 1.7), 7 fresh frozen plasma (7.5), 6 units packed red cells (SD 7) and 6 units cyoprecipitate (SD 8.3). The overall mean was survival 81 months (SE 6). The number of procedures, mean PCI, mean survival months (standard error), 5 year survival for the respective groups was 218, 23 (SD 11), 133 (SE 10), 76.7% 5 yr survival for PMP (DPAM), 190, 10 (SD 7.6), 39 (SE 3.6), 20% 5 yr survival for CRC, 118, 20 (SD 11) , 65 (SE 7.5), 43.3% 5 year survival for PMCA, 55, 19.4 (SD10), 63 (SE 7), 53.3% 5 year survival for mesothelioma and 30, 20 (9.6), 28.7 (SE 3), 16.7% with a 5 yr survival for remaining groups. Conclusion: Longterm outcome of peritonectomy in well selected patients in a major unit are encouraging.