Robotic Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (RCRS/HIPEC) for Gastrointestinal Cancers: Feasible and Safe

Abstract

Abstract Background Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is being increasingly utilized in the treatment of peritoneal surface malignancies. At the same time the use of robotic assistance in major oncological surgeries is increasing nationwide. We describe our initial outcomes with robotic assisted CRS/HIPEC technique (RCRS/HIPEC). Methods Our patients are a 40-yo female with BMI 17 and history of signet ring cell gastric adenocarcinoma s/p FOLFOX and robotic total gastrectomy then recurrence 2.5years later found during hysterectomy s/p 6 cycles of 5fu/irinotecan and nivolumab with no radiologically evident disease and a 49-yo female with BMI 37 and recently found low grade mucinous appendiceal neoplasm during appendectomy with radiologically confined disease at the right lower quadrant. Results Patients underwent cytoreduction with the use of the Xi robotic system. Peritoneal carcinomatosis index (PCI) was PCI = 4 and PCI = 5. Both patients underwent a complete cytoreduction (completeness of cytoreduction score, CC = 0). Perfusion for 90 minutes with mitomycin C at 41-42C was performed. Estimated blood loss for both cases was less than 50ml, patients returned bowel function at postoperative day 3 and were discharged on postoperative day 5 without complications.