Skip to content
Mesothelioma.net
phone iconCall1-800-692-8608 chat icon Chat 24/7 Live Chat
Menu
  • Malignant Mesothelioma
    • About Mesothelioma
      • How to Survive Mesothelioma
      • 100 Questions & Answers about Mesothelioma (Free Book)
      • Symptoms
      • Diagnosis
      • Prognosis
      • Life Expectancy
    • Types
      • Pleural
      • Peritoneal
      • Epithelioid
      • Sarcomatoid
      • Biphasic
    • Stages
      • Stage 1
      • Stage 2
      • Stage 3
      • Stage 4
    • Additional Information
      • Causes
      • Asbestos and Its Dangers
      • Facts
      • Support
      • Financial Compensation
      • FREE Mesothelioma Packet
  • Treatment
    • Treatment Options
      • Surgery
      • Chemotherapy
      • Radiation Therapy
      • Multimodal Therapy
      • Medications
      • Palliative Treatment
    • Find Top Doctors
      • Doctors
      • Treatment Centers
      • Treatment & Doctors Near You
      • New Treatments
      • Care Providers
      • Clinical Trials
      • Costs
  • Asbestos Trusts
  • Compensation
  • Veteran Assistance
    • Mesothelioma and Veterans
      • VA Claims for Mesothelioma
      • Vietnam Veterans
    • Military Branches and Asbestos
      • Navy Veterans
      • Navy Ships
      • Marine Corps Veterans
      • Army Veterans
      • Air Force Veterans
      • U.S. Coast Guard
  • Surviving Mesothelioma
  • About Us / Contact
  • Home
  • ›
  • Malignant Mesothelioma
  • ›
  • Treatment
  • ›
  • Surgery
  • ›
  • Peritonectomy/Cytoreductive Surgery
Page Updated: June 30, 2022

Peritonectomy/Cytoreductive Surgery

Paul Sugarbaker, M.D. Page Medically Reviewed and Edited by Paul Sugarbaker, M.D.

FREE Mesothelioma Packet

Fact Checked

This page has been fact checked by a Medical Doctor who specializes in mesothelioma. Sources of information are listed at the bottom of the article.

FREE Mesothelioma Packet

We make every attempt to keep our information accurate and up-to-date.

Please Contact Us with any questions or comments.

Peritonectomy/cytoreductive surgery is a treatment for peritoneal mesothelioma that removes all or some of the peritoneum and cancerous tissue. It improves survival rates when surgeons follow this procedure with HIPEC, hyperthermic intraperitoneal chemotherapy. A cure may even be possible.

FREE Mesothelioma Packet

Peritoneal Mesothelioma

The peritoneum is the part of the mesothelium that lines the abdominal cavity and the organs inside. The pleural form of mesothelioma is most common because this type of cancer is strongly associated with inhaling asbestos fibers.

However, a person may also swallow the fibers. Inhaled or ingested fibers may also migrate from the chest cavity to the abdominal cavity, causing tissue damage that leads to peritoneal mesothelioma.

Survival rates for peritoneal mesothelioma tend to be poor. About one-quarter of people diagnosed will live for three or more years. Treatment can extend life expectancy.

If the cancer diagnosis is in the early stages, there is a slight chance of a cure or remission. The best way to achieve remission is by surgically removing cancerous tissues.

What Is a Peritonectomy?

Peritonectomy is a form of cytoreductive surgery. Cytoreductive surgery is any surgical procedure that removes cancerous tissue.

The term peritonectomy refers specifically to the removal of the peritoneum.[1] The surgery may also remove parts of organs with cancerous tissue. Organs that may be affected are the small intestines, large intestine, gallbladder, liver, stomach, pancreas, and spleen.

Surgeons mostly use this procedure to relieve symptoms.[1] It may also slow progression and lead to remission, although the latter is not always possible.

The procedure is often combined with chemotherapy to improve the odds of remission and reduce the chance of a recurrence after surgery. This combination can eliminate cancer cells the surgeon could not safely remove or were too small to visualize during surgery.

Hyperthermic Intraperitoneal Chemotherapy

For peritoneal mesothelioma, HIPEC is often used after surgery. HIPEC is an innovative chemotherapy method that injects heated chemotherapy drugs directly into the abdominal cavity.

This differs from traditional chemotherapy, which administers drugs intravenously, allowing the drugs to circulate through the entire body.[2]

HIPEC is proven more effective for treating peritoneal mesothelioma than standard chemotherapy. Some studies found that treatment with HIPEC gives patients significantly extended survival times.[3]

This is a major achievement for treating a disease that was previously so difficult to manage. The increased survival time after HIPEC is associated with the epithelial subtype of mesothelioma.

Benefits of Peritonectomy

There are several goals of peritonectomy followed by HIPEC. These procedures tend to be palliative, aiming to reduce symptoms, extend survival times, and achieve the best chance at long-term remission.

Curing peritoneal mesothelioma is a realistic goal for some patients. Patients in earlier stages of the disease have a better opportunity for long-term remission.

For most mesothelioma patients, this surgery is used to extend life. For those with advanced cancer, a benefit of peritonectomy is relief from symptoms. Removing tumors in the abdomen can reduce pain and swelling, allowing the patient to feel more comfortable.

Risks and Complications

Peritonectomy followed by HIPEC is major surgery. While it may be less risky than radical surgeries used to treat pleural mesothelioma, it can still have significant complications.

Older patients or those with complex medical conditions are more likely to have postoperative complications from the surgery, yet anyone is susceptible.

Possible postoperative complications include:[4]

  • Fistulas from the bowels
  • Leakage from sites where the bowel was sutured together
  • Excessive bleeding
  • Intra-abdominal infection
  • Blood clots
  • Infections

Organ Damage and the Need for an Ostomy

Anytime there is an operation in the abdominal cavity, there is a small risk of injury to the bowel or urinary tract. If injury or obvious tumor involvement prohibits the surgical repair, an ostomy might be necessary.

An ostomy is a surgical procedure that diverts the digestive or urinary tract to the outside of the body. The procedure creates an opening, called a stoma, that links the small intestine, large intestine (colon), or ureter to the outside of the body, bypassing the normal routes through which waste is expelled from the body.[4]

Doctors typically perform ostomies when the bladder or bowels cannot function normally due to disease. In rare cases, organ damage may occur as a complication of surgery.

It is not a common complication, but any abdominal surgery, including a cytoreductive surgery, may result in damage that requires an ostomy. The ostomy may be permanent or may only be temporary to allow affected tissue to heal.

Living with an ostomy presents many challenges. Patients need an ostomy bag to collect feces or urine. The stoma does not have a valve to shut off the flow, the patient cannot control when waste passes from the body.

Specialty ostomy nurses are an invaluable resource to provide a plan for management, including problem-solving for any issues that arise. It can be emotionally challenging to deal with complex body image changes. These can either be temporary or permanent. If a reversal is possible, it will require another surgery.

Recovery

Recovery from cytoreductive surgery plus HIPEC varies by patient. Younger, healthier patients and those in earlier cancer stages typically recover more quickly and with fewer complications. If there is a complication, patients must remain in the hospital after surgery and HIPEC chemotherapy.

Patients may receive intravenous medications and fluids after surgery. Initially, there is often a tube to drain the stomach until normal bowel function returns. The goal is to return to a modified diet as soon as possible. Having a nutritionist can be very helpful in providing new dietary recommendations. Once patients go home, they will be on modified activity until fully recovered.

Peritoneal mesothelioma is a serious and aggressive cancer. The prognosis for this illness is generally poor; however, innovative treatment options have increased survival times. Cytoreductive surgery, including peritonectomy followed by HIPEC, is an effective way to help patients live longer.

For some, this procedure may even provide a cure. If you are facing treatment for peritoneal mesothelioma, know your options. Your medical team can help you understand the risks and benefits of these aggressive treatments for peritoneal mesothelioma.

Get Your FREE Mesothelioma Packet

Page Medically Reviewed and Edited by Paul Sugarbaker, M.D.

Paul Sugarbaker, M.D.

Dr. Paul Sugarbaker is a leading expert in surgical oncology. He specializes in the surgical treatment of gastrointestinal cancers, peritoneal mesothelioma, and peritoneal metastases. He developed and advanced an important treatment procedure for peritoneal cancers and metastases known as HIPEC. The innovative strategy uses surgery followed by the circulation of heated chemotherapy drugs in the abdomen. Dr. Sugarbaker currently heads up the Peritoneal Surface Malignancy Program and the Center for Gastrointestinal Malignancies at Washington Hospital Center. He also works out of a private practice, Sugarbaker Oncology Associates.

Connect with Mesothelioma Doctor Paul Sugarbaker, M.D.
References
  1. Cancer Research UK. (2018, September 7). Treatment Decisions for Peritoneal Mesothelioma.
    Retrieved from: https://www.cancerresearchuk.org/about-cancer/mesothelioma/treatment/decisions-peritoneal
  2. Cleveland Clinic. (n.d.). About the HIPEC Treatment.
    Retrieved from: https://my.clevelandclinic.org/departments/digestive/depts/hipec#about-tab
  3. Feldman, A.L., Libutti, S.K., Pingpank, J.F., Bartlett, D.L., Beresnev, T.H., Mavroukakis, S.M., Steinberg, S.M., Liewehr, D.J., Kleiner, D.E., and Alexander, H.R. (2003, December). Analysis of Factors Associated With Outcome in Patients With Malignant Peritoneal Mesothelioma Undergoing Surgical Debulking and Intraperitoneal Chemotherapy. J. Clin. Oncol. 21(24), 4560-7.
    Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/14673042
  4. Mehta, S.S., Bhatt, A., and Glehen, O. (2016, June). Cytoreductive Surgery and Peritonectomy Procedures. Indian J. Surg. Oncol. 7(2), 139-51.
    Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818624/
View All References

Site Navigation

Home
Malignant Mesothelioma
How to Survive Mesothelioma
100 Questions & Answers about Mesothelioma (Free Book)
Surviving Mesothelioma - Beating the Odds (Free Book)
FREE Mesothelioma Packet
Symptoms
Shortness of Breath
Cough
Night Sweats and Fever
Weight Loss
Pain
Difficulty Swallowing
Fatigue and Muscle Weakness
Gastrointestinal Complications
Diagnosis
Pathology
Staging
Stage 1
Stage 2
Stage 3
Stage 4
Metastasis and Progression
Brain Metastasis
Biopsy
miRview Test
Imaging
Fine Needle Aspiration Biopsy in Mesothelioma
Biomarkers and Blood Tests
Calretinin
Prognosis
Remission
Recurrence
Death Rate
Life Expectancy
Search for a Mesothelioma Cure
Types
Pleural
Peritoneal
Epithelioid
Sarcomatoid
Biphasic
Pericardial
Testicular
Cell Types
Rare Subtypes of Mesothelioma
Deciduoid
Desmoplastic
Heterologous
Lymphohistiocytoid
Well-Differentiated Papillary
Tubulopapillary
Small Cell
Benign
Adenomatoid
Cystic
Unresectable
Localized
Idiopathic
Omental
Causes
Risk Factors
Latest Research
Genetic Components
Incidence
Latency Period
Mesothelioma Tumor
Health Insurance Coverage
Related Conditions
Immunodeficiency Disorders
Cholangiocarcinoma
Atelectasis
Pleural Plaques
Pleural Thickening
Pleural Effusion
Peritoneal Effusion (Ascites)
Mesothelial Hyperplasia and Proliferation
Pleuritis and Pleurisy
COPD
Anemia
Breast Cancer
Prevention
Complications
Misdiagnosis
Mesothelioma Commercial
Talcum Baby Powder
Lawyer
Lawsuits
Class Action Lawsuits
Settlements
Simian Virus 40
Differences From Other Cancers
Lung Cancer
Women
Children and Young Adults
Unknown Asbestos Exposure
Mesothelioma Without Asbestos
Cause of Death
Facts 
History
Awareness
Government and Research
National Mesothelioma Virtual Bank
Support
What to Expect
Living with Mesothelioma
Help a Loved One
Wrong and Right Things to Say
Caregivers
Financial Tips
Faith
Nutrition and Lifestyle
Intimacy
Mesothelioma and Fertility in Men
Fertility in Women with Mesothelioma
Emotional Health
COVID-19
Assisted Living
Hospice Care
Dying from Mesothelioma
Mourning
Coping Guide for Children
End-of-Life Decisions
Mesothelioma Awareness Day
Compensation for Victims
Lawyer
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington D.C.
Washington
West Virginia
Wisconsin
Wyoming
Lawsuit
Settlements
Statute of Limitations
Treatment
Surgery
Side Effects
Pneumonectomy
Extrapleural Pneumonectomy
Lobectomy
Pleurectomy/Decortication
Post Op Care
Pleurectomy/Decortication vs. Extrapleural Pneumonectomy
Peritonectomy/Cytoreductive Surgery
Thoracotomy
Thoracoscopy
Pericardiectomy
Wedge Resection
Pleurodesis
Pericardiocentesis
Prosthetics
Paracentesis
Thoracentesis
Chemotherapy
Side Effects
Heated Intraperitoneal
Radiation Therapy
Side Effects
Intensity-Modulated
Brachytherapy
Proton Therapy
Image-Guided
External Beam
Three-Dimensional
Multimodal Therapy
New Treatments
SMART Protocol
Gene Therapy
Suicide Gene Therapy
Tumor-Based p53 Therapy
Cryotherapy for Mesothelioma
Tumor Treating Fields
MicroRNA
Palliative Treatment
Osteopathic
Doctors
Treatment Centers
Treatment & Doctors Near You
Mesothelioma Experts
Medications
Alimta (pemetrexed)
Adriamycin (doxorubicin)
Avastin (bevacizumab)
Cytoxan (cyclophosphamide)
Gemzar (gemcitabine)
Keytruda (Pembrolizumab)
Mitomycin
Navelbine (vinorelbine)
Opdivo (nivolumab) and Yervoy (ipilimumab)
Paraplatin (carboplatin)
Platinol (cisplatin)
Rheumatrex (methotrexate)
Sutent (sunitinib)
Taxol (paclitaxel)
Medical Marijuana
Care Providers
Clinical Trials
Anetumab Ravtansine
Atezolizumab
Chimeric Antigen Receptor (CAR) T-Cell
Durvalumab
Immunotoxin
Interferon Alfa-2b
Onconase (Ranpirnase)
VISTA Protein
Costs
Immunotherapy
Nanotechnology
Hyperbaric Oxygen Therapy
Home Medical Equipment
HMGB1 Secretion
Photodynamic Therapy
Targeted Therapies
Apoptosis
Stem Cells
Lung Transplantation
Body-Based Therapies
Alternative Therapies
Paul Kraus’s Method
Doctors and Treatment in Canada
Asbestos Trusts
Veterans
VA Claims for Mesothelioma
Vietnam Veterans
Military Branches and Asbestos
Navy Veterans
Navy Ships
Aircraft Carriers
Battleships
Destroyers
Asbestos on Navy Cruisers
Submarines
Amphibious Ships
Minesweepers
Auxiliary Ships
Marine Corps Veterans
Army Veterans
Air Force Veterans
U.S. Coast Guard
Asbestos
Occupational Exposure
Construction Workers
Shipyard Workers
Ship Repair
Steel Mill Workers
Industrial Workers
Boiler Workers
Power Plant Workers
Firefighters
Automotive Workers
Roofers
Oil Refineries
Mining
Transportation Industry
Machine Operators
Farmers and Agricultural Workers
Migrant Workers
Electrical Wiring
Labor Unions
Prisons
Chimneys, Furnaces, and Wood Stoves
Fiberglass Connection to Mesothelioma
Home Remodeling
School Buildings, Teachers
For Tech Students
Cancer
Lung Cancer
Pleural Based Cancers
Ovarian Cancer
Ovarian Cancer Lawsuits
Companies That Used Asbestos
Awareness and Education
Types of Asbestos & Mesothelioma Risk
Asbestosis
Interstitial Lung Disease
Smoking
Asbestos Ingestion
Exposure in a Natural Disaster
Ban Asbestos
Libby, Montana
Recycling Asbestos
Asbestos Detection
Legal Information by State
Canada
Mexico
United Kingdom
Australia
  • Malignant Mesothelioma
    • Treatment
    • Asbestos Trusts
  • Compensation
    • Veteran Assistance
    • Surviving Mesothelioma
  • FREE Mesothelioma Packet
    • Mesothelioma News
    • About Us / Contact
  • Privacy Policy
    • Disclaimer
    • Editorial Guidelines and Standards
This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.
The information provided by Mesothelioma.net is not a substitute for professional medical advice, diagnosis or treatment.

Mesothelioma.net

5430 LBJ Freeway Suite 1200
Dallas, Texas 75240

Serving mesothelioma victims nationwide

1-800-692-8608

  • facebook
  • twitter
© 2022 Mesothelioma.net