Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Heated chemotherapy delivered directly into the abdominal cavity during surgery, used in selected cases of peritoneal tumor spread.
What Is the Procedure?
HIPEC stands for Hyperthermic Intraperitoneal Chemotherapy — a treatment in which a heated chemotherapy solution, maintained at a specific temperature, is circulated directly within the abdominal cavity for approximately 60 to 90 minutes during the surgery itself.
The concept behind this treatment is to deliver a high concentration of chemotherapy directly to tissue surfaces inside the abdomen, while reducing the body's systemic exposure compared to conventional intravenous chemotherapy. The elevated temperature also helps enhance the local effectiveness of certain chemotherapy agents.
HIPEC is never used as a standalone treatment — it is always performed together with cytoreductive surgery, which aims to remove visible tumor deposits first.
Why Is It Performed?
- To target microscopic residual cancer cells on tissue surfaces within the abdomen after removal of visible tumors
- To reduce the likelihood of local tumor recurrence within the abdominal cavity in carefully selected cases
Who May Be Considered?
- Highly carefully selected patients with limited peritoneal tumor spread originating from the colon, stomach, ovary, appendix, or rare primary peritoneal tumors
- Patients whose overall health status allows them to tolerate a long, major operation
- After confirming that visible tumors can be removed completely, or nearly completely, during surgery
How Is It Performed?
- The procedure begins with cytoreductive surgery to remove all visible tumors from the abdominal cavity
- A heated chemotherapy solution, maintained at a specific temperature, is then introduced into the abdominal cavity
- The solution circulates within the abdominal cavity for approximately 60 to 90 minutes with continuous movement to ensure it reaches all internal surfaces
- After the set duration, the chemotherapy solution is drained, and the surgeon closes the abdomen
Preparation
- Comprehensive, multidisciplinary assessment including CT imaging, nutritional status, and vital organ function
- In-depth discussion with the patient about the nature of this major surgery and the expected recovery course
- Optimizing overall health and nutritional status before surgery as much as possible
- Advance coordination with the anesthesia and intensive care teams given the surgery's long duration
Anesthesia Overview
The entire procedure is performed under general anesthesia with close, continuous monitoring of cardiac and kidney function and core body temperature throughout the surgery, which may extend several hours
Expected Hospital Stay
This surgery requires a stay in an intensive or advanced care unit during the initial days after the operation
Total hospital stay typically ranges from two to three weeks depending on individual recovery
General Recovery Information
- Recovery is among the longest of any surgery, given the extent of the accompanying cytoreductive surgery
- Close monitoring of kidney and liver function and nutritional status during the initial weeks after surgery
- Gradual, careful progression in physical activity and diet under the medical team's guidance
- Full recovery and return to normal activity may take several months
Potential Risks & Complications
- Bleeding or infection
- Leak at bowel anastomosis sites
- Temporary effects on kidney function related to chemotherapy exposure
- Fluid and electrolyte imbalances requiring close monitoring after surgery
- Rarely, need for reoperation
Follow-Up
- Close, multidisciplinary follow-up after hospital discharge
- Periodic imaging and blood tests to monitor treatment response and any early signs of disease recurrence
- Ongoing coordination between surgery and medical oncology to determine the need for any additional treatment
Frequently Asked Questions
What is HIPEC treatment?
It is heated chemotherapy delivered directly into the abdominal cavity during surgery, aiming to target microscopic residual cancer cells left after removing visible tumors.
Who needs HIPEC surgery?
HIPEC is not a suitable option for all peritoneal tumor patients; suitability is determined after careful assessment of disease extent and overall health by a specialized medical team.
How is HIPEC performed?
It begins with cytoreductive surgery to remove visible tumors, followed by circulating a heated chemotherapy solution within the abdominal cavity for 60 to 90 minutes before draining it and closing the abdomen.
What is the difference between HIPEC and cytoreductive surgery?
Cytoreductive surgery is the surgical removal of visible tumors, while HIPEC is the localized chemotherapy delivered immediately afterward within the same operation to target remaining microscopic cells. Both are performed together in the same procedure.
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The information provided on this page is for educational purposes and does not replace individual medical evaluation.