Cytoreductive surgery program in Nonprofit Organization National Cancer Institute
Kopetskyi V., Kryzhevskyi V., Shudrak A., Cheverdiuk D., Huivaniuk I., Kushnir O.
Summary. Background. The combination of cytoreductive surgical intervention with an intra-abdominal hyperthermic chemotherapy session is currently an established method for treating peritoneal carcinomatosis. There are numerous challenges in implementing a new treatment program for malignant conditions of the peritoneum in a low-income country, particularly concerning perioperative management and resource allocation. Methods. We analyzed a retrospective database to assess the immediate surgical outcomes from 2017 to 2023 in patients with peritoneal carcinomatosis and the impact of the program on the distribution of hospital and human resources. The Carcinomatosis Center team developed patient selection criteria, perioperative assessment checklists, and recommendations for material and personal requirements for surgical and anesthetic support. Results. A total of 176 cytoreductions were analyzed, with 93 completed with HIPEC. The average operation time was 5.5 hours. The median of blood loss was 250 ml, eliminating the need for transfusion. No additional medical and support staff were required for intensive care and surgical departments. The average postoperative hospital stay was 7.4 days. Three patients died, resulting in a 1.7% 60-day mortality rate. Postoperative complications of Clavien — Dindo class III and higher occurred in 37 patients (21%). Conclusion. This new program did not lead to a significant redistribution of resources among other oncological service lines within the same institution
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