Hannover లో Prof. Beate Rau దగ్గర ఈ specific techniques కోసం train అయ్యాను. Hyderabad లో CRS+HIPEC మరియు PIPAC రెండూ offer చేస్తున్నాను. I trained specifically for these techniques under Prof. Beate Rau in Hannover. I offer both CRS+HIPEC and PIPAC in Hyderabad.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy) peritoneal surface malignancy కి advanced surgical treatment. Process: first cytoreductive surgery (CRS) తో abdomen లో visible tumour deposits అన్నీ remove చేస్తాను. తరువాత heated chemotherapy (42°C) abdomen లోపల 60-90 minutes circulate చేస్తాను. Microscopic residual cells eliminate చేయడం goal.
ఈ technique Sugarbaker (Washington DC) మరియు Glehen (Lyon, France) groups develop చేశారు. Initially "terminal" అని consider చేసిన peritoneal cancers లో, CRS+HIPEC long-term disease control, selected cases లో potential cure achieve చేయగలదు అని established అయింది.
నా Hannover ESSO Fellowship specifically peritoneal surface malignancy కోసం. Prof. Beate Rau గారి దగ్గర PCI (Peritoneal Carcinomatosis Index) scoring, patient selection, procedure execution, post-op management అన్నీ specifically నేర్చుకున్నాను. ఈ training India లో rare.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is an advanced surgical treatment for peritoneal surface malignancy. The process: first I perform cytoreductive surgery (CRS) to remove all visible tumour deposits from the abdomen. Then heated chemotherapy (42°C) is circulated inside the abdomen for 60-90 minutes to eliminate microscopic residual cells.
This technique was developed by the Sugarbaker group (Washington DC) and Glehen group (Lyon, France). Cancers previously considered terminal have shown that CRS+HIPEC can achieve long-term disease control and potential cure in selected cases.
My Hannover ESSO Fellowship was specifically for peritoneal surface malignancy. Under Prof. Beate Rau, I learned PCI scoring, patient selection, procedure execution and post-op management for these cases specifically. This training is rare in India.
Open surgery. All visible tumour surgically remove చేసిన తరువాత, heated chemo abdomen లో circulate. Best candidates: PCI score 20 కంటే తక్కువ, good performance status, resectable disease. 8-12 hour procedure.Open surgery. After all visible tumour is surgically removed, heated chemo is circulated in the abdomen. Best candidates: PCI score below 20, good performance status, resectable disease. 8-12 hour procedure.
Pressurised Intraperitoneal Aerosol Chemotherapy. Laparoscopic, minimally invasive. Open CRS+HIPEC candidates కానివాళ్ళకి. 6 weeks కి repeat చేయవచ్చు. Disease control అవుతుంది. Bridge therapy గా use చేయవచ్చు.Pressurised Intraperitoneal Aerosol Chemotherapy. Laparoscopic and minimally invasive. For patients not suitable for open CRS+HIPEC. Can be repeated every 6 weeks. Achieves disease control and can be used as bridge therapy.
CRS+HIPEC is the standard of care. Best long-term outcomes of all peritoneal surface malignancies.
Appendix-origin. Sugarbaker technique. Potentially curative with complete cytoreduction.
Selected cases with PCI below 20. PRODIGE 7 trial evidence base.
Interval debulking + HIPEC. OVHIPEC trial (NEJM 2018) showed survival improvement.
Carefully selected cases. Tumor Board evaluation required. PCI and disease biology determine candidacy.
PCI above 20, poor performance status, significant comorbidities, distant metastases beyond peritoneum. I tell patients honestly when they are not candidates.