Hyperthermic intraperitoneal chemotherapy (HIPEC) is a type of chemotherapy where the solution containing the drug is heated and delivered directly to the abdominal cavity during surgery. The term “Intraperitoneal” means that the treatment is delivered to the abdominal cavity. The term “Hyperthermic Chemotherapy” means that the solution containing chemotherapy is heated to a temperature greater than normal body temperature.
The procedure is done under general anaesthesia in the operating room. In the initial part- cytoreductive surgery involves removal of the primary tumor along with the involved organs by advanced surgical techniques and the later part involves intra-abdominal instillation of heated chemotherapy with specialized catheters and circulating machine.
While conventional chemotherapy circulates throughout the body in the bloodstream, HIPEC delivers chemotherapy directly to the cancer cells within the peritoneum (the lining of the abdomen). This increases efficacy of the treatment because the cells are subjected to higher doses of chemotherapy and the heated solution also improves the absorption of the drug by the tumor cells and destroys microscopic cancer cells that remain in the abdomen after surgery.
Before patients receive HIPEC treatment, the surgeons perform surgery to remove the tumor within the abdomen. When the maximum possible number of tumours have been removed, a heated, sterilized chemotherapy solution is delivered to the abdomen to penetrate and destroy the remaining cancer cells. The solution is heated to the temperature of a warm bath approximately up to 41-42 degree Celsius [between 105 and 109 F]. It is then circulated throughout the abdomen for approximately 90 minutes. The solution is then drained from the abdomen, and the incision is closed.
The entire procedure on the whole is a major surgical undertaking and the surgery takes place over a time period of 8 to 10 hours.
Possible Side Effects of HIPEC Surgery:
- CRS and HIPEC is a major operation and has the effects associated with major surgery including possible need for ICU care, nutritional support, abnormalities in liver and kidney function and risk of bleeding and wound related issues
- Specific effects include alteration of blood parameters such as magnesium and other electrolyte levels