What Is a Peritonectomy for Mesothelioma?
A peritonectomy is a commonly used treatment for malignant peritoneal mesothelioma.
A peritonectomy is a surgical procedure in which doctors remove the parietal peritoneum (the outer lining of the abdomen).
A peritonectomy for mesothelioma might be performed as part of a more extensive treatment known as cytoreductive surgery or debulking. This treatment was developed by peritoneal mesothelioma specialist Dr. Paul Sugarbaker in 1995 and has become the gold standard in treating this cancer.
Cytoreductive surgery removes the peritoneum and cancer neoplasms (growths or tumors) through a peritonectomy. Other surgical techniques and heated chemotherapy will also be used during cytoreductive surgery to help patients.
If you’re looking to get a peritonectomy surgery or other top mesothelioma treatments, we can help. Connect with skilled specialists now using our Free Mesothelioma Doctor Match.
What to Expect During a Peritonectomy for Mesothelioma
1. Surgical Consultation
The first step is a consultation with a surgical oncology (cancer) team. Consultations let patients meet the surgical team virtually or in-person to learn about cytoreductive surgery and the peritonectomy procedure.
During the consultation, oncologists will review the patient’s medical records and see if cytoreductive surgery will be a good fit for their case. They also will provide guidance about how to prepare for the surgery and what to expect afterward.
2. Cytoreductive Procedure
Peritonectomy for mesothelioma and cytoreductive surgery are performed under general anesthesia. During the procedure, the team will remove the peritoneum and as much cancerous tissue as possible.
Dr. Sugarbaker’s peritonectomy procedure involves performing the surgery up to six times on different spots within the abdomen to get rid of all the cancerous tumors.
The doctors may also remove cancerous portions of nearby organs like the liver if the cancer has spread (metastasized). Instead of a peritonectomy, a different surgical technique called resection is used in these cases.
3. Heated Chemotherapy
Once the peritonectomies and overall cytoreductive surgery have been completed, doctors will treat the patient with hyperthermic intraperitoneal chemotherapy (HIPEC) to destroy microscopic cancer cells.
This is performed by administering heated chemotherapy drugs right into the surgery site. Doxorubicin, mitomycin C, and cisplatin are the most commonly used HIPEC medications, as noted in a report published in the journal BJS Open.
In total, cytoreduction with HIPEC can take up to 10 hours, according to the University of Maryland Medical System.
4. Peritonectomy Recovery
After getting cytoreductive surgery — including peritonectomy and HIPEC — the patient can expect a hospital stay ranging from 8-22 days while they recover, as noted by Moffitt Cancer Center.
Patients will also likely receive food and fluids through an IV at first before returning to a solid diet.
Once discharged, the patient should rest at home for a few more weeks. Moffitt Cancer Center notes that it takes 3 months in total to recover from cytoreduction with HIPEC. The patient should attend follow-up appointments with their oncologists after discharge.
Not sure if you’re a candidate for a mesothelioma peritonectomy? Contact us now.
Peritonectomy Side Effects and Risks
Patients who undergo a peritonectomy for mesothelioma could suffer from postoperative side effects or complications.
Peritonectomy complications include:
- Excessive bleeding
- Ileus (intestinal muscles won’t contract)
- Leakage from surgery site
- Nausea and vomiting
- Pulmonary embolism (blockage in pulmonary arteries)
- Renal (kidney) damage
- Shortness of breath
- Urinary tract infections
Severe complications like fistulas (abnormal connections between organs), sepsis, and morbidity (death) can also occur in some patients who receive mesothelioma peritonectomies as part of cytoreductive surgery.
If the patient experiences any of the symptoms above after discharge, they should call their health care team as soon as possible to get help.
Who Can Undergo a Peritonectomy for Mesothelioma?
Doctors can see if you can safely undergo cytoreduction with HIPEC once your peritoneal mesothelioma diagnosis is confirmed.
Ideally, patients should be in good overall health if they want to receive this surgery. This is because cytoreduction with HIPEC is very aggressive and taxing on the body.
Doctors will also need to see how far the cancer has spread through the patient’s body before starting any treatment plan.
Some peritoneal mesothelioma patients have cancer that’s unresectable, meaning a peritonectomy and other surgeries won’t remove it fully. Other patients may not want to undergo major surgery. In these cases, doctors will recommend using chemotherapy alone to shrink cancer tumors, according to a 2020 report in the journal Translational Lung Cancer Research.
How Peritonectomy for Mesothelioma Affects Prognosis
As part of cytoreduction with HIPEC, a peritonectomy for mesothelioma can greatly improve a mesothelioma patient’s prognosis (health outlook). It’s possible for many patients to achieve long-term survival following this treatment.
A 2022 report published by the Journal of Clinical Medicine looked at past studies in which patients were treated with cytoreductive surgery and HIPEC.
The study authors found:
- The life expectancy of peritoneal mesothelioma patients ranged from 3-5 years
- The 5-year survival rates (number of patients still alive after 5 years) were between 36% and 53%
Some peritoneal mesothelioma patients have lived for 15 years or more following this treatment plan.
Without undergoing treatments like a peritonectomy for mesothelioma, patients typically live for 6 months to 1 year, as noted in a 2020 report published by Translational Lung Cancer Research.
Read more about patients who were able to outlive their prognosis after getting treatment in our Free Mesothelioma Survivors Guide.
Find Out if Mesothelioma Peritonectomy Is Right for You
If you or a loved one has peritoneal mesothelioma and are interested in undergoing a peritonectomy, reach out to Mesothelioma Hope now. For over 20 years, our team has helped mesothelioma patients and their families access life-changing treatment.
We can connect you with:
- Doctors and cancer centers that treat mesothelioma
- Financial resources to help cover medical expenses
- Resources to help cope with cancers caused by asbestos exposure
- Skilled mesothelioma nurses
Get started on your path to healing right now using our Free Doctor Match.
Peritonectomy for Mesothelioma FAQs
What is the success rate of peritonectomy?
When performed as part of cytoreductive surgery, the success rates of peritonectomy for peritoneal mesothelioma patients is high.
A 2022 study published in the Journal of Clinical Medicine found that up to 53% of patients were still alive 5 years after they received cytoreduction with HIPEC.
A peritonectomy for mesothelioma is a crucial part of what makes cytoreductive surgery a success, as it allows doctors to remove cancer tumors from the abdominal lining.
What is the life expectancy of someone with peritoneal mesothelioma?
The average life expectancy of peritoneal mesothelioma patients ranges from patients 3-5 years, provided that they get a peritonectomy, cytoreductive surgery, and HIPEC.
What is the best treatment for peritoneal mesothelioma?
If the patient is looking to live longer, aggressive treatments like cytoreduction with HIPEC and a peritonectomy for mesothelioma will be the most effective. By getting these treatments, patients have a better chance at becoming long-term survivors.
If the patient can’t receive life-extending treatment options due to peritoneal metastasis (cancer spread past the abdominal lining), they can undergo palliative care.
Palliative treatments can improve quality of life and ease symptoms like ascites (fluid buildup in the abdomen). Palliative treatments include fluid drains, pain-relieving medications, and systemic chemotherapy.
Finally, peritoneal mesothelioma patients may look into receiving clinical trials (in which new treatments are tested) if standard therapies don’t work for them.
What is the surgery for peritoneal mesothelioma?
The most effective surgery for peritoneal mesothelioma is called cytoreduction with HIPEC.
Doctors first perform peritonectomies and other surgeries to remove the cancer from the abdominal lining and parts of the gastrointestinal tract. Then they send warm chemotherapy drugs into the abdomen to destroy leftover cancer cells.
This treatment can help some peritoneal mesothelioma patients live for years or even decades. It can also help patients with other peritoneal surface malignancies (cancers) like ovarian cancer.