HIPEC surgery

HIPEC surgery in Iran

HIPEC (Hyperthermic Intraperitoneal Chemotherapy)

What is HIPEC?

Hyperthermic (or Heated) Intraperitoneal Chemotherapy (HIPEC) is a surgical procedure that’s giving new hope to patients with abdominal cancers. Immediately after removing visible tumors through what’s called cytoreductive surgery, your surgeons pump a powerful dose of heated chemotherapy inside a patient’s abdomen.

In fact, HIPEC is a cancer treatment that pumps warm chemotherapy drugs into your abdomen. You get one very large dose of chemotherapy, but it's not as toxic. That’s because the drugs aren’t injected into your bloodstream, so they don’t move around your body as much as chemotherapy given through an IV.

The chemotherapy drugs are heated to about 105-109 degrees F. Cancer cells can't handle heat as well as healthy cells. The heat also helps the drugs enter your cells more easily and work better.

 

HIPEC is major surgery, and you'll spend time recovering in the hospital.

Read more about : What is Radiation Therapy?

Before Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

What kinds of cancer can be treated with this procedure?

The most common tumors treated by HIPEC are:

. Colorectal cancers

. Appendix tumors such as

  . Pseudomyxoma peritonei

  . Low-grade appendiceal mucinous neoplasm

. Mesothelioma

. Adrenal cancer

. Ovarian cancer

. Malignant ascites

. Pancreatic cancer

. Desmoplastic small round cell tumors (typically occurs in adolescents or young adults)

. Peritoneal cancer

. Stomach (gastric) cancer

. Other locally advanced cancers in the abdomen.

Who are the good candidates for HIPEC Treatment?

As with any aggressive treatment, not all patients are eligible for HIPEC treatment.

Peritoneal mesothelioma patients must:

. Be healthy enough for surgery

. Not have heart disease or other serious chronic conditions

. Not have more than one bowel obstruction or partial obstruction

. Have a low peritoneal cancer index score (which estimates tumor growth and tumor spread).

. Have an epithelial cell type (other cell types are carefully considered)

Doctors look for patients who are otherwise healthy except for their cancer diagnosis. They conduct assessments to determine a patient’s overall health, which they call performance status.

Read more about : Cancer treatment

What are the benefits of HIPEC procedures?

. HIPEC allows for a higher concentration of chemotherapy to be delivered into the abdomen more effectively and safer than standard chemotherapy, which is delivered intravenously.

. This type of chemotherapy is best at killing cancer cells that are too small to be seen with the naked eye.

. Chemotherapy delivered through HIPEC causes fewer side effects than intravenous chemotherapy. This is because the high concentrations of chemotherapy solution are unable to cross what is known as the peritoneal plasma barrier.

. Experts say that pairing surgery and HIPEC together may be more beneficial than chemotherapy alone.

Side Effects of HIPEC

. Bleeding

. Wound infections

. Urinary tract infections

. Blood clots

. Pneumonia

. Bowel obstruction

. Disruption of normal bowel motility (which reduces appetite)

. Fistula (a connection between the skin and intestines)

. Myelosuppression (bone marrow produces fewer platelets and blood cells)

. Sepsis

During Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

The HIPEC process

The procedure has two phases: Cytoreductive surgery followed by heated chemotherapy.

Phase I: Surgery

First, doctors perform cytoreductive surgery to remove as much tumor growth as possible from the abdominal cavity. You'll get general anesthesia, so you won’t be “awake” for it.

HIPEC without surgery is ineffective because the chemo drugs cannot penetrate deep into cancerous tumors. In some cases, complete removal of the tumors is impossible and patients may need to explore other treatment options.

Phase II: Chemotherapy Bath

Mesothelioma doctors any remaining cancer cells with heated chemotherapy immediately after surgery to extend survival and prevent cancer recurrence.

The usual chemotherapy drugs, including carboplatin, cisplatin, doxorubicin, gemcitabine and pemetrexed, have all been used for heated chemotherapy. Instead of injecting these drugs into your blood, doctors deliver them directly to the chest or abdomen.

How the HIPEC machine works?

. Doctors insert catheters into the abdominal cavity and connect them to the perfusion system, which heats the chemotherapy solution and pumps it to and from the body.

. As the solution flows through the machine, a heating element raises it to between 105 and 109 F. Cancer cells start to die when heated to around 104 F, while normal cells can survive up to 111 F.

. A doctor massages the abdomen by hand to ensure the solution is fully mixed. This step helps the drugs reach remaining cancer cells.

. The chemotherapy drugs flow between the patient and perfusion system for about one hour.

. When the chemotherapy bath is finished, doctors drain the medicated solution from the body.

. The cavity is later rinsed with only a saline solution before the catheter is removed and incision is closed.

The entire procedure, including surgery and HIPEC, may take between six and 18 hours to complete because surgery times vary. The more the cancer has spread within the abdomen, the longer surgery will take.

After Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Recovery after HIPEC

After surgery, you'll spend about 2 days in intensive care. Doctors and other health care professionals will check you for fluid loss and will test your electrolytes and blood glucose levels.

You'll get insulin if your blood sugar level gets too high because this can slow down wound healing, make infection more likely, and cause other problems. You'll most likely get antibiotics to help ward off infection. And you'll be given pain meds while the surgical wound heals, probably in the form of an epidural.

As for eating, you might start off with IV nutrition, but the goal will be for you to eat solid foods as soon as possible. Doing so will help get your bowel function back to normal faster.

Once you move out of intensive care, you'll stay at the hospital to continue healing for another 6-20 days, on average, while you recover.

The most challenging aspect of recovery is fatigue. It will likely take two to three months until you begin to feel back to normal. Until then, it is important to stay active (within your limits) and maintain good nutrition.

Read more about : The most successful HIPEC surgery for the first time in Iran

10 common questions about HIPEC surgery in Iran

1What is the success rate of Hipec surgery?
"With HIPEC, it is possible to completely cure 25 to 30 percent of patients with these types of cancer," says Dr. Wasif.
2How long does it take to recover from Hipec surgery?
Patients typically remain in the hospital for 10-12 days following surgery. Once a patient is discharged from the hospital, the team from Tufts Medical Center will work with the patient and their family to ensure that home care needs are met.
3Is Hipec surgery dangerous?
Despite the complexity of the operation, a HIPEC procedure is now considered very safe. The chances of dying as a result of complications after treatment is less than 3% in experienced HIPEC centers. These odds compare favorably to other high-risk surgical procedures.
4What are the side effects of Hipec?
That means the typical side effects of chemotherapy, such as hair loss, diarrhea and mouth sores, often can be avoided. There can be other side effects associated with HIPEC, however. To get the best effect with this procedure, the chemotherapy is left inside the abdominal cavity for about 90 minutes before removal
5Can Hipec be done laparoscopically?
HIPEC is conventionally performed as an open surgical technique, and is frequently associated with major open abdominal surgery leading to prolonged post-operative recovery times. However, HIPEC may be performed laparoscopically in cases requiring limited or no tumor debulking
6What is the life expectancy for peritoneal cancer?
6 weeks – 6 months Life expectancy If left untreated, the median survival time for peritoneal cancer patients may be as short as six weeks for patients who have pancreatic cancer or six months for patients who have colon cancer
7Is Hipec covered by insurance?
A: HIPEC is not experimental and studies have verified that it is an effective and safe procedure in experienced medical centers. It is a procedure that is covered by insurance, and our team has experience with helping obtain insurance coverage for both in-state and out-of-state patients.
8Can Hipec cure colon cancer?
Peritoneal carcinomatosis occurs in about 20% of people with metastatic colorectal cancer. ... Surgery with HIPEC may prolong survival (compared to systemic therapy alone), and surgery may cure up to 16% of patients with peritoneal carcinomatosis
9How aggressive is appendix cancer?
The recurrence rate is low for early stage and less aggressive forms of appendix cancer. The survival rate for appendix cancer is high. ... 85 percent if the cancer has spread to regional, or close, organs. 34 percent if the cancer has spread to distant organs, but this is very rare for carcinoid tumors
10What chemo is used in Hipec?
HIPEC surgery, also known as heated or hyperthermic intraperitoneal chemotherapy, is the process of heating chemotherapy drugs and delivering them into the abdominal cavity. This treatment is often combined with cytoreductive surgery and is an effective approach for peritoneal mesothelioma

2 Comments

  1. Morad Roudbaraki says:

    سلام،
    از فرانسه با شما تماس میگیرم.
    یکی از هموطنان در ساری دچار
    peritoneal carcinomatosis
    میباشد و احتیاج به درمان با HIPEC دارد. ولی متاسفانه، وضعیت مالی خوبی ندارند.
    میتوانید لطفا بگویید آیا شما درمان با HIPEC را انجام میدهید و اگر چنین است، چه مبلغی برای این درمن لازم است ؟
    و اگر انجام نمیدهید، میتوانید لطفا مرا راهنمایی کنید برای پیدا کردن بیمارستانی که چنین درمانی را انجام میدهند ؟
    از قبل از لطفتان تشکر فراوان دارم.
    پروفسور م. رودبارکی

    دانشگاه لیل در فرانسه

    HIPEC surgery
    HIPEC surgery in Iran
    HIPEC (Hyperthermic Intraperitoneal Chemotherapy)

    • Iranian Surgery Adviser says:

      Hello and Good morning
      hope you having a good day
      Dr Akrami in Shiraz can do HIPEC Surgery AT shahid Faghihi Hospital.
      keep in mind that patient need to rest at hospital for 10 to 14 days. you can bring the patient to Shiraz for check up or send their Medical information on what’s app and Contact us via this number +989019290946
      با سلام و روز بخیر
      در شیراز دکتر اکرمی در بیمارستان شهید فقیهی انجام می‌گیرد و مراجعه کننده باید 10 الی 14 روز در بیمارستان بستری باشند
      ایشون باید تشریف یبیارند و مدارک پزشکی خودشون رو ارائه بدهند ودر صورت امکان در شیراز عمل بشوند

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