Peritonectomy for Mesothelioma

Peritonectomy is a surgical procedure to remove the lining of the abdominal cavity. It’s often performed as part of cytoreductive surgery — in which cancer is removed from the abdomen — to help pleural mesothelioma patients live longer. Learn more about peritonectomy for mesothelioma and get help finding doctors near you for treatment.

Fact-Checked and Updated by: Jenna Tozzi, RN

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What Is a Peritonectomy for Mesothelioma?

A peritonectomy is a commonly used treatment for malignant peritoneal mesothelioma.

Peritonectomy Definition

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.

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What to Expect During a Peritonectomy for Mesothelioma

Below is an overview of what patients can expect leading up to, during, and after 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.

Did You Know?

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
  • Fever
  • Ileus (intestinal muscles won’t contract)
  • Infections
  • Leakage from surgery site
  • Nausea and vomiting
  • Pneumonia
  • 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.

Peritonectomy for Mesothelioma Video Thumbnail

A peritonectomy is a commonly used surgery for peritoneal mesothelioma. It allows doctors to remove the abdomen lining and any cancer tumors found inside. This surgery may be able to help you or a loved one live longer after a peritoneal mesothelioma diagnosis. View Transcript.

Duration: 1 min 01 sec

If you or a loved one has been diagnosed with peritoneal mesothelioma you may have heard of a surgical procedure called peritonectomy. This procedure involves removing the lining of the abdominal cavity which can help mesothelioma patients live longer. A peritonectomy is often performed as part of cytoreductive surgery which is a comprehensive cancer treatment aimed at removing as many visible abdominal tumors as possible. This type of surgery has been shown to greatly improve survival time for peritoneal mesothelioma patients. A peritonectomy is a complex procedure performed by a team of highly trained surgeons and can take several hours to complete. Our team can help you access top treatments like a peritonectomy if you qualify. We work with leading Cancer Centers across the country to provide patients with the best possible care. Mesothelioma Hope is here to support your family at every step of your cancer journey. To learn more about peritonectomy and other treatment options for mesothelioma, contact us today.

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.

Did You Know?

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.

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.

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Find Doctors for Mesothelioma Peritonectomy

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
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Call us at (866) 608-8933 or use our Free Doctor Match service to get started.

Peritonectomy for Mesothelioma FAQs

What is the life expectancy of a peritonectomy patient?

For patients with peritoneal mesothelioma, undergoing a peritonectomy combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can significantly increase life expectancy.

The average life expectancy for these patients is 3-7 years, depending on the stage of the cancer, how much of the patient’s tumors their surgeon is able to remove, and other factors.

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.

What is the recovery time for a peritonectomy?

Recovery from a peritonectomy can take time. Most patients stay in the hospital for 10 to 14 days, though it may be longer if there are complications. The first 4 to 6 weeks involve significant rest, with limited physical activity and some pain or fatigue.

Full recovery usually takes 3 to 6 months, though some patients may take longer to regain their strength. Regular follow-ups are needed to check for complications like infection or bowel issues, and patients may need to adjust their diet and activity level as they heal.

Jenna TozziWritten by:

Chief Patient Care Advisor

Jenna Tozzi, RN, is the Chief Patient Care Advisor for Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to cancer patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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References
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  2. Brandl, A., et al. (2020, January 20). “Clinical and surgical outcomes of patients with peritoneal mesothelioma discussed at a monthly national multidisciplinary team video-conference meeting.” Retrieved December 4, 2024, from https://bjssjournals.onlinelibrary.wiley.com/doi/10.1002/bjs5.50256
  3. Cancer Council Australia. (December 423). “Understanding Mesothelioma.” Retrieved December 4, 2024, from https://www.cancer.org.au/assets/pdf/understanding-mesothelioma-cancer-booklet
  4. Cancer Research UK. (2023, January 11). “Surgery for peritoneal mesothelioma.” Retrieved December 4, 2024, from https://www.cancerresearchuk.org/about-cancer/mesothelioma/treatment/surgery/peritoneal-mesothelioma
  5. Greenbaum, A., & Alexander, H. R. (2020, February 9). Translational Lung Cancer Research. “Peritoneal mesothelioma.” Retrieved December 4, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082256/#
  6. Li, C., et al. (2022, March 29). Journal of Clinical Medicine. “Treatment of Patients with Malignant Peritoneal Mesothelioma.” Retrieved December 4, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999919/
  7. McMullen, J. R. W., Selleck, M., Wall, N. R., & Senthil, M. (2017). Peritoneal carcinomatosis: limits of diagnosis and the case for liquid biopsy. Oncotarget, 8(26), 43481–43490. Retrieved December 4, 2024, from https://doi.org/10.18632/oncotarget.16480
  8. Mehta, S. S., Bhatt, A., & Glehen, O. (2016). Cytoreductive Surgery and Peritonectomy Procedures. Indian journal of surgical oncology, 7(2), 139–151. Retrieved December 4, 2024, from https://doi.org/10.1007/s13193-016-0505-5
  9. Mehta, S. S., Gelli, M., Agarwal, D., & Goéré, D. (2016). Complications of Cytoreductive Surgery and HIPEC in the Treatment of Peritoneal Metastases. Indian journal of surgical oncology, 7(2), 225–229. Retrieved December 4, 2024, from https://doi.org/10.1007/s13193-016-0504-6
  10. Moffitt Cancer Center. (n.d.). “How Long Does It Take to Recover From a HIPEC Surgery?” Retrieved December 4, 2024, from https://moffitt.org/treatments/surgical-care/cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy/recovery/
  11. Saadeh, R., et al. (2022, February 15). European Journal of Gynaecological Oncology. “Total parietal peritonectomy for 61 patients: A retrospective study.” Retrieved December 4, 2024, from https://article.imrpress.com/journal/EJGO/43/1/10.31083/j.ejgo4301009/2709-0086-43-1-009.pdf
  12. St. George Peritonectomy & Liver Cancer Unit. (n.d.). “Post-Surgery.” Retrieved December 4, 2024, from https://stgeorgeperitonectomy.com.au/for-patients/patient-information/post-surgery/
  13. Sugarbaker, P. (2013, April 27). Translational Gastrointestinal Cancer. “Cytoreductive surgery using peritonectomy and visceral resections for peritoneal surface malignancy.” Retrieved December 4, 2024, from https://tgc.amegroups.com/article/view/1710/2386
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