Dados do Trabalho

Título

CYTOREDUCTIVE SURGERY AND PERIOPERATIVE HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY: INITIAL EXPERIENCE IN THE PUBLIC HEALTH SYSTEM

Apresentação do Caso

The National Commission for the Incorporation of Technologies in the Unified Health System approved the inclusion of Cytoreductive Surgery (CRS) and perioperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Public Health System for patients with Mesothelioma and Pseudomyxoma Peritonei (PM), with effects operational and financial starting in June 2022. Since then, through this agreement, we have carried out nine CRS and HIPEC (Wake Forest University Oxaliplatin Regimen) in our service. The distribution of perioperative information and early patient outcomes are shown in tables 1 to 2.

Discussão

Since the 1980's, the introduction and widespread use of CRS and HIPEC has provided a treatment option improving prognosis, outcome, and quality of life with potential for cure for patients with PM. This technique includes the removal of macroscopic tumor implants by means of multivisceral resections and peritoniectomies associated with hyperthermic perfusion of the peritoneal cavity with chemotherapeutics (by open or closed technique). The intraperitoneal route of administration allows exposure of microscopic tumor remnants to high concentrations of chemotherapeutic agents, while hyperthermia adds synergism to their cytotoxic effects by allowing greater penetration of these into tissues.

Comentários Finais

The initial experience of demonstrated feasibility and acceptable morbidity in performing the procedure in our service under the Public Health System agreement.