Peritoneum కి cancer spread అయినప్పుడు, tumour deposits multiple sites లో ఉంటాయి. Abdominal organs surface పైన, omentum, mesentery, diaphragm, pelvic structures. CRS goal: ఈ visible deposits అన్నీ surgically remove చేసి "complete cytoreduction" achieve చేయడం. Residual disease ideally 0mm.
Complete cytoreduction achieve చేయడానికి multi-organ involvement common. Small bowel, colon, spleen, gallbladder, uterus, ovaries, peritoneal strips, omentum, diaphragm peritoneum — అవసరమైనవి remove చేయవలసి రావచ్చు. 6-12+ hours typically. Specialised training, experienced anaesthesia, ICU support అవసరం.
PCI (Peritoneal Carcinomatosis Index) 0-39 scale పైన score చేస్తాను. Score 20 కంటే తక్కువ cases లో complete cytoreduction achieve చేయడం, మంచి outcomes రావడం more likely. ఇది patient selection కి critical tool. Prof. Rau దగ్గర ఈ assessment specifically నేర్చుకున్నాను.
When cancer spreads to the peritoneum, tumour deposits are present at multiple sites: on the surface of abdominal organs, the omentum, mesentery, diaphragm and pelvic structures. The goal of CRS is to surgically remove all these visible deposits and achieve "complete cytoreduction" — ideally zero millimetres of residual disease.
Achieving complete cytoreduction often involves multiple organs. Small bowel, colon, spleen, gallbladder, uterus, ovaries, peritoneal strips, omentum and diaphragm peritoneum may all need to be removed. Typically 6-12+ hours. Specialised training, experienced anaesthesia and ICU support are all essential.
I score each case on the PCI (Peritoneal Carcinomatosis Index) scale of 0-39. Cases with a score below 20 are more likely to achieve complete cytoreduction with good outcomes. This is a critical patient selection tool that I learned specifically under Prof. Rau.