Chapters Transcript Video Cytoreductive Surgery and HIPEC Rod L. Flynn, MD, discusses the utilization of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for advanced abdominal cancers. So high peck is a, is an acronym for heated intraperitoneal chemotherapy. This is a modality that we use for patients who have very advanced cancers. Give an example back in the day. Uh you have a patient with cancer safe from the colon and it essentially explodes into the abdominal cavity and these patients would present with milder maybe even significant symptoms. They would be taken to the operating room and a surgeon would open up the patient and close them back up and then that patient would then be told that they don't have much time to get their affairs in order. Sometimes they'd be given some palliative chemotherapy and then they'd end up succumbing to their disease. So nowadays we don't have to do that in a lot of cases now. And so what we do. We have a technique where we actually don't close those patients back up, we we say they present with symptoms, they get testing and they are found to have cancer disseminated within their abdominal cavity or we have a peritoneal surface malignancy program whereby then we get those patients in seen and evaluated, get the appropriate imaging scans tests and what have you and then we make a decision of whether or not this patient can actually have their entire tumor removed. This procedure. High peck is done in conjunction with what we call site a reductive surgery, which is where we go in and we will remove all visible cancer. And this procedure can take anywhere from five hours to 15 or 16 hours, depending on the extent of disease. Our goal being to remove all of the macroscopic cancer cells in the abdomen. We follow that up at the same setting with a heated chemotherapy solution. With the goal being the chemotherapy bathes the abdominal cavity to kind of mop up any little microscopic cells that were floating around that we were not able to see at the time of surgery. This procedure usually runs for about 90 minutes. The we call it a belly wash or Or a shake and bake. We have different terms that we use for that. But basically we do distribute, it's almost like a washing machine. So we distribute the chemotherapy, the heated chemotherapy in the admin for usually on the average of 90 minutes and then we go back and make sure everything is nice and clean and we close the patient up. This is followed usually by chemotherapy afterward. And our goal is to take these patients who were once thought to have no hope and they were opened and closed. And then their life expectancies were limited to giving patients a new lease on life where they can live normal and functional lives. And that's um one of the areas of my most special interests because of the journeys of these patients when they get this diagnosis and they think it's all over and then they come to see us and we give them hope and then we actually follow through on that and to see patients. My longest surviving patients thus far, she's 10 years out from her surgery and she's doing great. And I get pictures every year and it's just it's just so gratifying and rewarding. And then again, just to make sure that we understand it's not an individual effort. You know, we have a whole team that helps to take care of these patients from the beginning to their uh, to the completion of their treatment and beyond. And so sad. Reductive surgery. And high peck is is a is a real deep passion of mine because we take patients with no hope and give them hope. Published August 17, 2021 Created by Related Presenters Rod Flynn, MD Surgical Oncology View full profile
