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MANAGEMENT OF
PERITONEAL SURFACE MALIGNANCY
USING
INTRAPERITONEAL CHEMOTHERAPY
AND
CYTOREDUCTIVE SURGERY
A Manual for Physicians and Nurses
|
Paul H. Sugarbaker, M.D., F.A.C.S.
Washington Cancer Institute
110 Irving Street NW Washington, DC 20010
Third Edition
All rights reserved. Reproduction in
whole or in part by any means without permission of the author is
prohibited.
French, Italian and Turkish translations are available.
Printed in the United States of America
The Ludann Company Grand Rapids, Michigan
November 1998
 |
Supported by an educational
grant from the |
TABLE OF CONTENTS
| Introduction | ||
| I. Principles of Intraperitoneal Chemotherapy | ||
| A. Peritoneal space to plasma barrier B. Tumor cell entrapment C. Change in the route and timing of chemotherapy administration D. Implementation of heated intraoperative intraperitoneal chemotherapy administration E. Prognostic groups of patients with peritoneal carcinomatosis F. Predicting outcome for mucinous adenocarcinoma by CT |
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| II. Current Indications for Cytoreductive Surgery and Intraperitoneal Chemotherapy | ||
| A. Large volume noninvasive adenocarcinoma B. Sarcoma and peritoneal mesothelioma C. Peritoneal Cancer Index D. Completeness of Cytoreduction score E. Successful treatment of microscopic residual disease F. Prevention of peritoneal carcinomatosis in high risk patients G. Debilitating malignant ascites |
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| III. Heated Intraoperative Intraperitoneal Chemotherapy by the Coliseum Technique | ||
| IV. Immediate Postoperative Abdominal Lavage in Preparation for | ||
| Early Postoperative Intraperitoneal 5-Fluorouracil | ||
| V. Early Postoperative Intraperitoneal Chemotherapy for Adenocarcinoma | ||
| VI. Induction Intraperitoneal Chemotherapy and Treatment for Debilitating Ascites | ||
| VII. Cytoreductive Surgery for Peritoneal Surface Malignancy - Peritonectomy Procedures | ||
| A. Position and incision B. Abdominal exposure, greater omentectomy and splenectomy C. Left upper quadrant peritonectomy D. Right upper quadrant peritonectomy E. Lesser omentectomy and cholecystectomy F. Pelvic peritonectomy with resection of the rectosigmoid colon G. Antrectomy and gastric reconstruction H. Total gastrectomy and reconstruction I. Tubes and drains required for heated intraoperative and early postoperative intraperitoneal chemotherapy |
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| VIII. Results of Treatment of Peritoneal Surface Malignancy | ||
| IX. Conclusions | ||
| References | ||
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