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320 Starting a hipec programme in a low resource setting
  1. A Peedicayil1,
  2. R Mittal2,
  3. A Joel3,
  4. E Rai4,
  5. A Sebastian1,
  6. V Thomas1,
  7. A Thomas1,
  8. R Chandy1 and
  9. K Subramani5
  1. 1Christian Medical College, Gynaecologic Oncology, Vellore, India
  2. 2Christian Medical College, Colorectal Surgery, Vellore, India
  3. 3Christian Medical College, Medical Oncology, Vellore, India
  4. 4Christian Medical College, Anaesthesia, Vellore, India
  5. 5Christian Medical College, Critical Care, Vellore, India


Objectives Hyperthermic IntraPeritoeneal Chemotherapy (HIPEC) after maximal cytroreduction is a promising modality of treating women with ovarian cancer. In order to determine the feasibility of setting up a HIPEC programme in India, we document our initial experience.

Methods Ethics Committee clearance was obtained to start the programme. The electronic medical records of all patients who underwent HIPEC in our department was reviewed.

Results A total of 14 patients underwent HIPEC in the first 2 years: one primary, 6 interval and 7 recurrent cytoreductions.

The women had a mean age of 46.9 years (36 to 62), median performance score of 1 (o to 2) and a median peritoneal carcinomatosis index (PCI) of 10 (2 to 25).

The histology was serous in 9, mucinous in 4 and endometrioid in one.

Four patients had bowel resection of whom 2 had an end ileostomy and one had an end colostomy. The median duration of surgery was 9 hours (5 to 10) and the median completeness of cytoreduction score was 1 (0 to 2). The drugs used in HIPEC were Cisplatin and Oxaliplatin. The median duration of hospital stay was 9 days (6 to 21).

Two patients were readmitted to hospital and 3 patients had re-laparotomy. The main complications were venous thromboembolism in one, bleeding in one and wound dehiscence in one.

Conclusions Cytoreductive surgery with HIPEC is feasible in a low resource setting with acceptable morbidity where the main limitations are non-availability of operating time and patient’s ability to pay for treatment.

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