HIPEC with Cytoreductive Surgery

HIPEC, hyperthermic intraperitoneal chemotherapy, is heated chemotherapy washed through the abdominal cavity at the end of a major operation called cytoreductive surgery, in which the surgeon removes all visible tumour deposits from the peritoneum, the lining of the abdomen. It is used for cancers that have spread across this lining.

For selected patients it can give long survival and, in conditions such as pseudomyxoma peritonei, possible cure. The benefit depends on removing all visible disease; it is a very large operation with serious risks, and for some cancers trial evidence for the heated chemotherapy part is mixed.

What HIPEC with Cytoreductive Surgery involves

Selection starts with CT, often PET-CT or MRI, tumour markers and a review of pathology by a multidisciplinary team; a diagnostic laparoscopy frequently scores how widespread the disease is (peritoneal cancer index). At surgery, through a long midline incision, the surgeon strips affected peritoneum and removes involved organs as needed: omentum, parts of bowel, spleen, gallbladder, ovaries and uterus. The aim is no visible tumour or nodules under 2.5 millimetres. Inflow and outflow tubes are then placed and a pump circulates chemotherapy solution, commonly mitomycin C, cisplatin or oxaliplatin, heated to 41 to 43 degrees, through the abdomen for 30 to 90 minutes. The fluid is drained, bowel joins are completed, sometimes with a temporary stoma, and you go to intensive care.

Who is a good candidate for HIPEC with Cytoreductive Surgery?

Only a minority of people with peritoneal spread are suitable, and an honest team will say so after reviewing scans.

• Pseudomyxoma peritonei and appendix tumours
• Peritoneal mesothelioma
• Colorectal cancer with limited peritoneal deposits and no spread elsewhere
• Stage III ovarian cancer at interval surgery after chemotherapy, where a randomised trial showed a survival benefit
• Good fitness and nutrition, able to withstand 6 to 12 hours of surgery

It is usually not the right choice if:

• Spread to liver (beyond a few removable spots), lungs or distant lymph nodes
• Extensive small bowel involvement that cannot be cleared
• Poor heart, lung or kidney function, or frailty
• Disease progressing quickly on chemotherapy
• Most stomach and pancreatic cancer with peritoneal spread, outside clinical trials

الخيارات التقنية

• Closed abdomen HIPEC: Skin is closed during perfusion; keeps temperature stable.
• Open (coliseum) technique: Abdomen kept open under a cover so the surgeon can stir fluid by hand.
• PIPAC: Pressurised aerosol chemotherapy given by laparoscopy for palliation when full surgery is not possible; still investigational.
• Systemic chemotherapy alone: The standard alternative when complete tumour removal is not achievable.

ماذا يحدث خلال علاجك

The operation lasts 6 to 12 hours under general anaesthesia with an epidural for pain. You wake in intensive care with drains, a urinary catheter, a nasogastric tube and sometimes a stoma. Expect 1 to 3 days in intensive care and 10 to 21 days in hospital in total. The bowel is slow to restart, and feeding through a vein or tube may be needed for a while.

الإعداد لرحلتك

Plan for 4 to 6 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

التعافي والنتائج

Full recovery takes 3 to 6 months. Fatigue, reduced appetite and weight loss are usual in the first weeks. Blood counts dip after the chemotherapy and are monitored. Most people need help at home for at least a month. Follow-up is with CT scans and tumour markers every 3 to 6 months, and further systemic chemotherapy is often planned, so care must be coordinated with your oncologist at home.

• Back to everyday activity: 3 to 6 months
• When results show: Judged on follow-up scans
• How long they last: Depends on cancer type and completeness of removal

سياسة السلامة والمخاطر والتنقيح

Major complications occur in roughly 1 in 4 to 1 in 3 patients, and the risk of death around surgery is about 1 to 3 percent in experienced centres.

• Leak from a bowel join, needing re-operation
• Abdominal infection, abscess or fistula
• Bleeding and blood clots in legs or lungs
• Low blood counts and kidney injury from the chemotherapy
• Prolonged bowel paralysis and nutritional problems
• Temporary or permanent stoma
• Cancer returning in the peritoneum or elsewhere

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of HIPEC with Cytoreductive Surgery in Türkiye

Clinic-Y does not publish a single price for HIPEC with Cytoreductive Surgery, because the honest figure depends on your case. What moves it:

• Extent of surgery and hours in theatre
• Days in intensive care and on the ward
• Chemotherapy agent and perfusion equipment
• Pre-operative staging scans and laparoscopy
• Treatment of complications, which can prolong the stay considerably

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

الأسئلة المتكررة