HIPEC Surgery: All you need to know

HIPEC surgery involves injecting high doses of chemotherapy into the abdomen to treat cancer that has progressed beyond the original organ.

What is HIPEC surgery?

HIPEC surgery (hyperthermic intraperitoneal chemotherapy) is a two-step procedure used to treat abdominal tumours. The treatment is the surgical removal of cancerous tumours (cytoreductive surgery), followed by the injection of hot chemotherapeutic chemicals into the abdomen to eliminate the remaining cancerous cells. 

HIPEC surgery involves injecting high doses of chemotherapy into the abdomen to treat cancer that has progressed beyond the original organ. Traditional chemotherapy can be difficult to treat abdominal malignancies that have progressed to the lining of the abdominal cavity (peritoneum). A more successful therapeutic option is HIPEC surgery.

What types of cancer does HIPEC surgery treat?

HIPEC treats the following types of cancers: 

• Appendix cancer
• Colon and rectal cancer
• Gastric (stomach) cancer
• Liver cancer
• Mesothelioma
• Ovarian cancer( evidence is sufficiently in favour )
• Pancreatic cancer
• Peritoneal cancer
• Adrenal cancer

How is HIPEC surgery performed?

HIPEC surgery has two stages: 

Cytoreductive surgery: The initial stage of HIPEC surgery is cytoreductive surgery. Your surgeon will create an incision in your belly while you are under anesthesia to view all visible malignant tumours and damaged tissue. 

The HIPEC procedure is the next step: Following the removal of all visible tumours and sick tissue from the abdomen, a catheter is placed with chemotherapy medications, which is pushed into your abdomen. The catheters are connected to a perfusion machine, which warms the chemotherapy medications and circulates them for one to two hours through your abdomen. Before closing the incision, the residual chemotherapy is drained from the abdomen and cleaned with a salt solution.

The length of the procedure depends on how far cancer has gone throughout the abdomen. While surgery for advanced-stage cancer may take longer to treat with surgery.

Duration of HIPEC Surgery

Procedures can take 8–10 hours long and carry a significant rate of complications.

Benefits of HIPEC

Improves drug absorption: Through HIPEC surgery, high doses can be delivered directly to the abdomen, where regular chemotherapy treatments are ineffective.

Same effect with minimal exposure to the rest of the body. In this way, the normal side effects of chemotherapy can be avoided.

Patients with inoperable or advanced-stage cancer may benefit from this novel surgery since it improves long-term outcomes and expands treatment options.

HIPEC Risks

Intestinal leaks, kidney failure, inflammation of the pancreas, sepsis, and a drop in bone marrow and blood cells. 

Typical side effects like nausea, vomiting, pain and weight loss usually ease up within 3 months but can last up to a year. Fatigue, sleep problems, bloating, diarrhea or constipation, and depression are also common.

Recovery After HIPEC

Following surgery, the patient is kept in intensive care for 1-2 days before being shifted to the ward for 3-5 days. Doctors and other medical professionals then examine the patient for signs of dehydration and test electrolytes and blood glucose levels. The fluid electrolytes of the patient are also being monitored closely until they are stabilized and the patient can eat solid meals and have bowel movements.

References:

• “HIPEC Surgery: What You Need to Know” John Hopkins https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hipec-surgery-what-you-need-to-know#:~:text=Hyperthermic%20intraperitoneal%20chemotherapy%20(HIPEC)%20surgery,eliminate%20the%20remaining%20cancerous%20cells.

About Author –

Dr. Sachin Subash Marda, Consultant Oncologist (Cancer Specialist), Yashoda Hospitals, Hyderabad
Dr. Sachin Subash Marda specializes in breast cancer, head & neck cancer, gastrointestinal cancers, gynecological and urological cancers. He has a vast experience in several robotic surgeries, laparoscopic surgeries, day care oncological procedures and HIPEC.