What are the three phases of HIPEC surgery? (Anai Kothari, MD)

Anai Kothari, MD, surgical oncologist, talks about the three phases of HIPEC surgery and how it is used to treat abdominal cancers. Dr. Kothari is part of the Froedtert & the Medical College of Wisconsin HIPEC team.

I usually break HIPEC surgery down into three phases.

  • The first is cytoreduction and that really is focused on eliminating the tumor from within the abdominal cavity. There's a lot of procedures that may go into doing that, and that includes removing a portion of the bowel, potentially other organs - like the spleen or the gallbladder. So really that first portion the goal is to eradicate or remove all the tumor that we can visibly see.
  • The next portion is actually the heated chemotherapy portion and, again, that's really meant to directly put chemotherapy on the target organ so that we're directly treating the tumor where it actually is.
  • And then the last portion of the operation is you know, since the first part is taking out potential organs or structures, is restoring continuity or putting everything back together. It's an important part from a quality of life and long-term standpoint to do that part well, and so we focus a lot of time and energy on ensuring that is kind of the third part of the operation.

After the surgery, the recovery is an inpatient recovery. On average patients will stay in the hospital between 7 and 10 days. A lot of that is actually dependent on, not the chemotherapy itself, but what was necessary during the operation to clear the tumor. The chemotherapy, of course, adds some additional recovery time on top of just recovering from surgery itself. I usually advise patients that the short-term recovery takes about 6 weeks overall and sometimes the ramifications, the effects of the surgery, can last even longer than that. But the key is that this is part of a multidisciplinary approach to treating this cancer.

Featured in this Video