Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment approach used for patients with malignant peritoneal mesothelioma (MPM), a rare and aggressive form of cancer that affects the lining of the abdomen. The goal of HIPEC is to eliminate any remaining cancer cells after cytoreductive surgery (CRS) by delivering heated chemotherapy directly into the peritoneal cavity. While HIPEC can be an effective treatment option for MPM, there are potential complications that patients should be aware of.
One of the most significant potential complications of HIPEC is the risk of infection. Because the procedure involves opening the abdomen and delivering chemotherapy directly into the peritoneal cavity, there is an increased risk of infection compared to other types of surgeries. In some cases, patients may develop peritonitis, an inflammation of the peritoneum, which can lead to serious complications such as sepsis. To reduce the risk of infection, patients are typically given antibiotics before, during, and after the procedure, and the surgical team takes great care to ensure that the peritoneal cavity is thoroughly cleaned and disinfected.
Another potential complication of HIPEC is damage to other organs or tissues in the abdomen. Because the procedure involves manipulating and heating the organs and tissues in the peritoneal cavity, there is a risk of damage to nearby structures. For example, the small intestine is particularly vulnerable to damage during HIPEC, and patients may experience bowel obstruction or other gastrointestinal complications after the procedure. To reduce the risk of organ damage, the surgical team carefully plans the CRS and HIPEC procedures and takes great care during the surgery to avoid damaging nearby structures.
In addition to infection and organ damage, there are other potential complications of HIPEC that patients should be aware of. These can include:
Pain: Patients may experience pain and discomfort after the procedure, particularly in the abdomen. Pain can be managed with medication and typically improves over time.
Nausea and vomiting: Some patients may experience nausea and vomiting after HIPEC, particularly as they recover from anesthesia.
Blood clots: There is a risk of blood clots after any surgery, including HIPEC. Patients are typically given blood thinners and encouraged to move around as soon as possible after the procedure to reduce the risk of clots.
Kidney damage: The chemotherapy used in HIPEC can be toxic to the kidneys, particularly if the patient has pre-existing kidney disease. Patients are carefully monitored after the procedure to ensure that their kidneys are functioning properly.
Delayed wound healing: Because HIPEC involves opening the abdomen, there is a risk of delayed wound healing. Patients are typically given specific instructions on how to care for their incisions after the procedure to minimize this risk.
It is important to note that not all patients will experience complications after HIPEC, and that the benefits of the procedure may outweigh the risks for many patients with MPM. However, it is important for patients to be aware of the potential complications and to discuss any concerns with their healthcare team before undergoing the procedure.