HIPEC, or hyperthermic intraperitoneal chemotherapy is an innovative procedure used to treat cancers that have originated in or spread to the abdominal cavity, such as appendiceal cancer, pseudomyxoma peritonei, colon cancer, gastric cancer, ovarian cancer, and peritoneal mesothelioma. But what happens after the surgery? We asked surgical oncologist, Martin Goodman, MD, Boston’s most experienced HIPEC surgeon, what patients can expect after the surgery and for follow-up care.
How long is the hospital stay after HIPEC surgery?
Cytoreductive surgery with HIPEC is an involved procedure that lasts an average of 8-14 hours, depending on the extent of disease. Patients typically remain in the hospital for 10-12 days following surgery. Once a patient is discharged from the hospital, the team from Tufts Medical Center will work with the patient and their family to ensure that home care needs are met. This includes the coordination of a visiting nurse, physical therapist and/or occupational therapist if necessary.
What is the HIPEC surgery recovery process?
Following cytoreductive surgery with HIPEC, it is not uncommon for patients to feel fatigued for 2-3 months post-operatively. While it is important to rest during this period of recovery, it is also important to get up, move around, and remain as active as possible. Remaining active will help combat fatigue as well as prevent possible complications of surgery, such as blood clots forming in the legs and pneumonia. Patients should continue doing the things they enjoy and set goals throughout their recovery. While the recovery process takes time, setting and accomplishing goals helps patients realize the progress they are making throughout their recovery period.
Is nutrition important during recovery?
Nutrition plays a significant role in maintaining health and wound healing. An oncology dietitian will evaluate the patient’s nutritional status both before and after surgery to ensure their caloric needs are being met. If total parenteral nutrition (TPN) is required, the dietitian will work with patients to ensure they receive the correct formulation. The dietitian also works with patients as they are weaned off TPN to ensure they continue to receive adequate nutrition. Most insurance companies cover appointments with the dietitian; however coverage should be confirmed.
What is the follow-up process?
Patients should expect to have a follow-up appointment with Dr. Goodman or a member of his team approximately 1-2 weeks after hospital discharge. During this visit, patients will also see the oncology dietitian to evaluate their nutritional status and create an individualized patient care plan. Additionally, follow up lab work for tumor markers CEA, CA19-9, and CA125 should be drawn every 3 months for the first 2 years postoperatively, then every 6 months for years 3-5. CT scans should be performed every 6 months for the first 2 years postoperatively, then annually for years 3-5. If at any point the tumor markers are elevated, additional CT scans will be ordered.