Cytoreductive Surgery

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Cytoreduction, also known as Cytoreductive Therapy, is a therapy focused on reducing the size of cancerous tumor. Two of the most common cytoreductive treatements are surgery and radiation therapy. These treatments are useful in debulking tumors.


What is Debulking?

As the name suggests, debulking refers to reducing the bulk. In this case, reducing the bulk of cancerous tumor. Since chemotherapy isn’t able to go past large and bulky tumors, debulking cytoreductive surgery may be suggested to the patients in order to increase the efficiency of chemotherapy. The goal of this surgery is to remove as much visible cancer as possible – the bulk of the cancerous tumor – and to ensure that there aren’t any remaining nodules that measure more than 2 centimeters in diameter. This surgery is especially recommended and may prove effective for patients who are in the advanced stage of cancer.


One of the most common symptoms following cytoreductive surgery is to feel fatigue. While it is important to rest post such an intensive surgery, it is important to move around as much and whenever you can. Frequent movement will help in preventing possible complications post the surgery, such as, blood cots and pneumonia, and also address fatigue. It is even more important for the patients to try and take up activities of their choice and set health goals throughout the recovery period. This will help patients get back to their normal routine, slowly and steadily, and help them to see their progress throughout the recovery period.


Cytoreduction therapy, when used with hyperthermic intraperitoneal chemotherapy (HIPEC), is advantageous in cases where cancer that have developed or spread to the abdominal cavity, such as appendiceal cancer, pseudomyxoma peritonei, colon cancer, gastric cancer, ovarian cancer, and peritoneal mesothelioma. These treatments are given in succession – Cytoreductive surgery, followed by HIPEC.

Cytoreductive surgery focuses on removing the visible parts of tumor, leaving behind only the microscopic cells. If the tumor has spread into other organs, it may be necessary to surgically remove those organs in order to free the affected area of the tumor. Gallbladder, spleen, part of the small or large intestine, and the lining of the abdominal wall (peritoneum) are some of the organs that may be removed.

This surgery is then followed by HIPEC – Hyperthermic Intra PEritoneal Chemotherapy – to destroy any remaining microscopic cancer cells. During HIPEC, heated chemotherapy solution is administered to abdomen to destroy any remaining cancerous cells. Once the treatment is over, chemotherapy solution is drained from the abdomen and the slit is closed using sterilized equipments. The temperature of the heated solution is maintained at 42-43°C because cancer cells die at approximately 40°C while a temperature of 44°C is required to destroy normal and healthy cells.

For further more details, Contact Dr.S.Ayyappan has specialised in Peritoneal Surface Malignancies performed many number of Cytoreductive and HIPEC Surgeries for diseases which are considered as inoperable.