Abstract Background Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) for peritoneal metastatic disease is mainly performed via open surgery. There is some evidence that this can be performed safely laparoscopically (L-CRS+HIPEC), however, it is unclear if outcomes are comparable. Methods A systematic search of PubMed and Web of Science during November and December 2024 using keywords laparoscopic, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy and neoplasm. Outcomes examined included; operative time, blood loss, complete cytoreduction, conversions to laparotomy, time to chemotherapy, morbidity/complications, disease free survival, overall survival and recurrence. Results 9 studies were included. Mean/median blood loss was significantly lower with L-CRS+HIPEC (p0.05). Conversion to laparotomy occurred in 36/149 patients before final selection for studies, but optimal cytoreduction (CC0-1) was completed in all patients in this review. The number of total morbidities was significantly lower with L-CRS+HIPEC in two studies. However, the difference in the number of severe complications (grade ≥3 Clavien-Dindo) was insignificant. Hospital stay was significantly shorter with L-CRS+HIPEC in all comparative studies, meaning so was return to chemotherapy (p0.05). There was no significant difference in recurrence, overall survival or disease-free survival after 1,2,3 or 5 years. Conclusions L-CRS+HIPEC shows similar oncologic outcomes to the open approach. It reduces morbidity and the time taken to return to adjuvant systemic chemotherapy. However, the literature is limited, more research is required as most current studies are small. Future work should focus on larger, high-quality research to understand if L-CRS+HIPEC is safe for this cohort.
Long et al. (Fri,) studied this question.