Cytoreductive surgery (CRS) in combination with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a highly specialized and established treatment which offers effective treatment for selected patients with peritoneal cancer that either originate in or metastasize (spread) to the abdomen.

The CRS is a technique which removes any visible cancerous tumours from the abdominal cavity. This is also called ‘debulking’ surgery. After the surgeons remove the cancerous tumours, the abdominal cavity is then bathed with a high dose of heated (usually to 42 degree Celsius) chemotherapy that aims to kill any remaining cancer cells.

CRS and HIPEC is now the standard of treatment for cancers such as pseudomyxoma peritoneii, metastatic appendiceal cancer, peritoneal mesothelioma and primary peritoneal cancer. In selected patients, this treatment is also effective for patients with colorectal cancer and ovarian cancers that have spread to the abdominal cavity, or other rare peritoneal cancers. However, not all patients with these cancers are suitable for CRS and HIPEC. If you have been affected by any of these cancers, you may wish to discuss the option of this treatment with your oncologist or our HIPEC surgeons.

Intravenous or oral chemotherapy does not always reach or adequately affect cancer cells. With HIPEC, the abdomen is bathed which allows chemotherapy to attack directly on the cancer cells, even in hard-to-reach areas. The heated chemotherapy also enhances the cytotoxicity efficacy. In addition, intraperitoneal bathing allows much higher doses to be delivered, while minimizing common side effects of intravenous chemotherapy such as nausea, fatique or hair loss etc as HIPEC agents do not circulate throughout your blood stream and attack healthy cells.

On the day of surgery, you will be given general anaesthesia. Surgeons will first remove as much cancer/tumours as possible. Following this, the chemotherapy solution will be heated to about 42 degree Celsius and bath inside your abdomen for 60-90 minutes.

Surgeons will then drain away the chemotherapy solution followed by copious washes to your abdominal cavity. You will be monitored closely following this procedure as part of the routine close monitoring following major surgery.