Feasibility and Efficiency of Extensive Cytoreductive Surgery for Pseudomyxoma Peritonei

Toshiyuki Kitai, Kennya Yamanaka* and Yuhei Okubo**

Department of Surgery, Nara Social Security Hospital
Department of Surgery, Osaka Red Cross Hospital*
First Department of Surgery, Kansai Medical University**

We report 6 cases of extensive cytoreductive surgery conducted from January 1999 to September 2004 on 2 men and 4 women aged 45 to 71 years suffering from pseudomyxoma peritonei. Two were initial operations and four reoperative. Complete cytoreduction was possible in 4 of the 6. Based on the Sugarbaker procedure, we conducted colectomy, omentectomy, splenectomy, left and right subphrenic peritonectomy, cholecystectomy, bursectomy, gastrectomy, low anterior resection, hysterectomy, and pelvic peritonectomy as needed. Intraperitoneal chemotherapy was added in 3 cases. Anastomotic failure was encountered in 1. Histology involved mucinous cystoadenoma or adenocarcinoma with low-grade malignancy. No recurrence has been seen in 4 cases of complete cytoreduction, although follow-up is yet short. In 2 cases of incomplete cytoreduction, the patient' quality of life (QOL) was markedly improved. Our results suggest that 1) extensive cytoreduction for pseudomyxoma peritonei is safe, 2) complete cytoreduction provides the possibility of a cure, and 3) even incomplete cytoreduction effectively improves the QOL.

Key words
pseudomyxoma peritonei, extensive cytoreductive surgery, sugarbaker procedure

Reprint requests
Toshiyuki Kitai Department of Surgery, Nara Social Security Hospital
1-62 Asahimachi, Yamatokoriyama, 639-1013 JAPAN

Accepted
November 30, 2005

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