Effect of Intraperitoneal Hyperthermic Chemoperfusion to Control Malignant Ascites in Patients with Peritoneal Carcinomatosis

How to control malignant ascites is one of the important problems for the patients with peritoneal carcinomatosis. In order to assess the efficacy of intraperotoneal hyperthermic chemoperfusion (IHCP), clinical outcome of the 8 patients who had malignant ascites and received IHCP was investigated. The origins of their peritoneal carcinomatosis were gastric cancer in 5 patients, ovarian cancer in 1 patient and unknown in 2 patients. IHCP was performed for 90120 minutes just after cytoreductive surgery under hypothermic general anesthesia. Heated perfusate with 10 μg/ml of mitomycin C (plus 1530μg/ml of CDDP in 2 patients) was circulated in the peritoneal cavity through a closed circuit. The inflow temperature and the outflow temperature of the perfusate were controlled to be 4446°C, and 4344°C, respectively. The mean amount of ascites of the 8 patients was 5425±3253 ml (120010000 ml). After the treatment, ascites disappeared in 7 of 8 patients (87.5%). The median ascites free duration of these 7 patients was 5 months (317 months). IHCP is suggested to be effective to control malignant ascites of the patients with severe peritoneal carcinomatosis. It may also give them better quality of life and opportunities to receive further treatment.