Laparoscopy for risk-reducing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (case series and review of literature)

Open cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is still considered the golden standard of treatment, but for well-selected patients, minimally invasive surgery is showing promising results in reducing overall morbidity and hospital stay with no apparent consequences on long-term outcomes.One area where minimally invasive modalities bring evident benefits is risk-reducing CRS plus HIPEC where usually the overall bulk of resections being made are procedures where laparoscopy already is the golden standard of treatment.We present a case series of three patients with type II low-grade appendiceal mucinous neoplasm (LAMN) who, after reviewing the pathological and radiological findings, were selected for risk-reducing laparoscopic CRS and HIPEC.One of the patients was converted to open surgery due to discrepancies between the intraoperative findings and the preoperative radiological assessment.The median follow-up was 17 months with no recurrence found.A review of the Pubmed database was performed and was in congruence with our experience: The role of laparoscopic CRS plus HIPEC in well-selected patients surpasses diagnostic or palliative purposes and is an important option especially when speaking about risk-reducing surgeries with several benefits concerning morbidity and noninferiority in long-term oncological outcomes.