Zeitschrift für Hepatologie und Magen-Darm-Erkrankungen
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CytoreductiveSurgery(CRS)+ Hypertermal Intraperitoneal Chemotherapy (HIPEC):First case series reported in Ecuador.

Rene Gordillo, Gabriel Medina, Veronica Angos, Daniela Gordillo

Peritoneal carcinomatosis which is still considered as a terminal disease by many oncological groups worldwide, is also underestimated by others, since the resective surgeries in which peritoneal implants are not evident, a large percentage of up to 30% of patients will develop carcinomatosis without being considered; it is because peritoneal carcinomatosis is one of the main means of tumor dissemination of intraabdominal organs. In Ecuador, a South American country, this tool has already been implemented since 2016, within a multidisciplinary group for the management of peritoneal surface malignancy. In this context, to date this group has reached and evaluated 37 patients, of which 14 patients were excluded because of their advanced disease, 15 were not performed by their own choice and this procedure was performed in 8 patients: 2 due to peritoneal pseudomyxoma, 2 due to gastric adenocarcinoma, 1 due to intraperitoneal melanoma of undetermined origin, 1 due to epithelial ovarian carcinoma, 1 due to adenocarcinoma of biliar origin, 1 due to synchronous colon adenocarcinoma with 3 primary lesions (this case was completely resolved by laparoscopy). Moreover, the selection criteria considered were the usual ones: Patients in good to a moderate general and nutritional condition, who had a computed axial tomography based peritoneal         carcinomatosis index of less than 15. In 2 of the cases, death occurred in the post-operative period in less than 30 days after surgery. However, in the other cases, survival was higher than 4 times the average. It is true that they are cases of variable origin pathologies and that the behavior is different in each one of them, the number of cases in this series does not allow to offer yet hopeful data, nevertheless we can extrapolate this information to large published series, in which an increase of up to 4-10 times the average survival rate is evident.