Article Text
Abstract
Introduction Hyperthermic Intraperitoneal Chemotherapy (HIPEC) continues to be a subject of debate in ovarian cancer, but also of increasing interest. The OVIHIPEC-1 Study showed improvement in overall survival when utilised following complete interval cytoreductive surgery. There is currently no clear evidence regarding HIPEC following primary or secondary cytoreductive surgery. However, trials are ongoing in these areas. Establishing a service can be challenging including decisions regarding administration technique. Therefore in 2022, the Peritoneal Surface Oncology Group International (PSOGI) produced a consensus statement regarding HIPEC in epithelial ovarian cancer which addressed aspects including indications and technique.
Description This video demonstrates both the Open and Closed administration techniques with HIPEC. The importance of clear standard operating procedures and teamwork is highlighted. Although each technique has advantages, the PSOGI group consensus could not identify that one technique was superior to the other, based on current evidence. Both therefore can be utilised for the administration of HIPEC in ovarian cancer. It is recommended that the chemotherapy agent used is Cisplatin with a minimum treatment time of 60mins at 41 degrees Celsius. Nephroprotection is achieved via the administration of Sodium Thiosulphate. Regardless of administration technique (Open vs Closed), it is important to establish good intrabdominal volume and flow, ensuring adequate exposure to all surfaces of the Cisplatin.
Conclusion/Implications Currently both the Open and Closed techniques can be utilised for the administration of HIPEC in ovarian cancer. We hope this video provides useful information regarding the techniques, peri-operative considerations and the infrastructural requirements required in the establishment of a service.