Peritonectomy procedures
and multivisceral exeresis. 
Sugarbaker's Technique.

 INTRODUCTION 

Until just a few decades ago, malignant disease of the peritoneum, or peritoneal carcinomatosis (PC) was considered by the medical community as a lethal tumoural condition, for which the only option was palliative care.

The clinical knowhow and experience gained in the USA, Japan and France in the 1980s opened up the way to a different, potentially curative therapeutic approach: the simultaneous combination of surgery and hyperthermic intraperitoneal chemotherapy. Today, this multidisciplinary approach has come to be seen as the standard for patients diagnosed with different types of PC. It offers survival rates never previously seen with any other form of treatment.

Surgery forms a fundamental part of this therapeutic binomial and must be radical (Cytoreductive Surgery or CRS) to justify the subsequent and immediate application of hyperthermic intraperitoneal chemotherapy (HIPEC). This then constitutes the multidisciplinary approach known as CRS+HIPEC.

CRS may be used in cases of PC when treated with the peritonectomy procedures described by Sugarbaker. These are surgical techniques that may also be applied to other areas of surgery and are thus of great interest to the general surgeon and others.  

Our intention with this Audio-visual Course on the Radical Multidisciplinary Treatment of PC and Peritonectomy Procedures, is to underscore the capital importance of CRS and didactically tackle the most relevant technical aspects of the procedures originally described by Sugarbaker and of some of the modifications later made to them. Single or multiple visceral exeresis is normally required for such surgery, and the approach will vary according to the organs affected and the type of PC.

Reconstruction of the digestive and/or urinary tract and the repair of abdominopelvic defects are essential after CRS. We will hear about different types of digestive/urinary anastomoses and techniques for the repair of abdominopelvic defects, and about the technical variations so essential to the work of the oncological surgeon.

All of the technical aspects of the different forms in which HIPEC may be applied will be examined in detail.

It is our aim during the course to refresh the indications and clinical results for the application of CRS+HIPEC for the most significant forms of PC: pseudomyxoma and peritoneal mesothelioma and colorectal, appendiceal, gastric and ovarian carcinomatosis, amongst others. These are all conditions with which such treatment is commonly used.

The content of the course will be built around the personal experience of the different keynote speakers, all of whom are international authorities, and by the ten years during which the Catalan Programme for Peritoneal Carcinomatosis has been running (over 1,200 applications of CRS, 700 of which associated with HIPEC).

The format of the course is innovative: video recordings and other graphic material covering the many and varied technical aspects of CRS will be shown and discussed. The expert panel will introduce each of the different subject areas tackled by the different videos (nearly 50 in all) shown over the course of the two days.

The main goal of the Course is to encourage the participation and engagement of all present.

We look forward to enjoying your company this June in Barcelona.

Dr. Pedro Barrios
Head of the Department of General and Digestive Surgery.
Integrated Health Consortium.
Sant Joan Despí-Moisès Broggi Hospital
and l'Hospitalet General Hospital
Barcelona, Spain
Head of the Peritoneal Carcinomatosis Programme for Catalonia