Department of Digestive Oncological Surgery, West Cancer Institute, Boulevard Jacques Monod, 44800, Saint Herblain, France.
Department of Digestive Surgery, University Hospital, Nantes, France.
Surg Endosc. 2020 Jun;34(6):2789-2795. doi: 10.1007/s00464-020-07492-w. Epub 2020 Mar 12.
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a long and complex procedure. A minimal invasive approach is rarely performed. The feasibility of laparoscopic CRS and HIPEC via a single port (SP) approach is unknown. The aim of this study was to assess the feasibility of CRS and HIPEC with a SP approach.
This study is IDEAL stage I-IIa. Patients with low grade and limited peritoneal malignancy were included in a tertiary care cancer center. Intra- and post-operative adverse events were recorded and classified according to medical and surgical dedicated classifications. The main objective measurement to assess feasibility was the conversion to open or multiport surgery.
A total of 12 highly selected patients were assessed. The median operating time was 240 min (range, 180-360) and two near miss events were reported. Two conversions to open and multiport surgery occurred. The median comprehensive complication index was 0 (range, 0-42.6) with two severe adverse events (Clavien-Dindo or CTC-AE ≥ 3). The median length of stay was 8.5 days (range, 5-13).
CRS and HIPEC via a laparoscopic SP approach are feasible and safe in the short term. The next step should be a prospective development study.
细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）是一个漫长而复杂的过程。很少采用微创方法。通过单端口（SP）途径进行腹腔镜 CRS 和 HIPEC 的可行性尚不清楚。本研究旨在评估通过 SP 途径进行 CRS 和 HIPEC 的可行性。
这是一项 IDEAL 分期 I-IIa 的研究。低级别和局限性腹膜恶性肿瘤患者被纳入三级癌症中心。记录术中及术后不良事件，并根据医疗和外科专用分类进行分类。评估可行性的主要客观测量指标是转为开放或多孔手术。
共评估了 12 名高度选择的患者。中位手术时间为 240 分钟（范围 180-360 分钟），报告了两起接近失败事件。有两例转为开放和多孔手术。中位综合并发症指数为 0（范围 0-42.6），有两例严重不良事件（Clavien-Dindo 或 CTC-AE≥3）。中位住院时间为 8.5 天（范围 5-13 天）。
通过腹腔镜 SP 途径进行 CRS 和 HIPEC 在短期内是可行且安全的。下一步应该是前瞻性发展研究。
