Tang Xin, Li Wenjuan, Zhang Xueyang, Ren Jiaqi, He Ziyan, Li Hongming, Yi Xiaojiang, Lu Xinquan, Feng Xiaochuang, Liao Weilin, Lin Jiaxin, Wang Jiahao, Diao Dechang
The Second Clinical Medical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
Department of Gastrointestinal Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China.
Eur J Surg Oncol. 2025 Feb;51(2):109496. doi: 10.1016/j.ejso.2024.109496. Epub 2024 Nov 24.
Patients diagnosed with pseudomyxoma peritonei (PMP) of appendiceal origin typically present with high tumor burden and require extensive cytoreductive surgery (CRS) to achieve optimal cytoreduction. This study describes an en bloc "rolled-up carpet" surgical technique for total parietal peritonectomy and multivisceral resection while also analyzing the perioperative and tumor outcomes of this technique.
The study reviewed the data of 7 patients underwent en bloc "rolled-up carpet" extensive CRS between August 2020 and April 2023. Perioperative and tumor outcomes were analyzed.
Seven patients underwent extensive treatment involving total peritoneal and multivisceral resection. Complete cytoreduction was successfully achieved in all patients. Six patients (85.7 %) successfully completed hyperthermic intraperitoneal chemotherapy (HIPEC). Three patients (42.9 %) had low-grade mucinous appendiceal neoplasm, while the remaining four patients (57.1 %) had high-grade. Two patients (28.6 %) experienced major morbidity, which was successfully treated, and they were discharged. There were no secondary surgery and no surgery-related mortality. During a median follow-up of 25 months (range, 12-46 months), no patient experienced recurrence. After 12 months postoperatively, the quality of life (QOL) of the 7 patients was assessed using the EORTC QLQ-C30, revealing scores similar to the reference values of the EORTC general population (p > 0.05).
En bloc "rolled-up carpet" extensive cytoreductive surgery is a feasible and safe technique for the treatment of appendiceal PMP with high tumor burden. This technique achieved complete cytoreduction with acceptable blood loss volume, operative time, and major morbidity. In short-term follow-up, no recurrence was noted, with patients having a satisfactory QOL.
诊断为阑尾源性腹膜假黏液瘤（PMP）的患者通常肿瘤负荷较高，需要进行广泛的细胞减灭术（CRS）以实现最佳的肿瘤细胞减灭。本研究描述了一种整块“卷起地毯式”手术技术用于全腹膜切除术和多脏器切除术，同时分析该技术的围手术期和肿瘤学结局。
本研究回顾了2020年8月至2023年4月期间7例行整块“卷起地毯式”广泛CRS患者的数据。分析围手术期和肿瘤学结局。
7例患者接受了包括全腹膜和多脏器切除的广泛治疗。所有患者均成功实现了完全肿瘤细胞减灭。6例患者（85.7%）成功完成了腹腔内热灌注化疗（HIPEC）。3例患者（42.9%）患有低级别黏液性阑尾肿瘤，其余4例患者（57.1%）患有高级别肿瘤。2例患者（28.6%）发生了严重并发症，但均成功治疗并出院。无二次手术且无手术相关死亡。在中位随访25个月（范围12 - 46个月）期间，无患者出现复发。术后12个月，使用欧洲癌症研究与治疗组织（EORTC）QLQ - C30对7例患者的生活质量（QOL）进行评估，结果显示得分与EORTC一般人群的参考值相似（p > 0.05）。
整块“卷起地毯式”广泛细胞减灭术是治疗高肿瘤负荷阑尾PMP的一种可行且安全的技术。该技术实现了完全肿瘤细胞减灭，失血总量、手术时间和严重并发症均可接受。在短期随访中，未观察到复发，患者生活质量令人满意。
