| Theme | Advancement of Medical Practice for Peritonitis and Ascites | |
|---|---|---|
| Title | Pseudomyxoma Peritonei | |
| Publish Date | 2019/07 | |
| Author | Kensuke Otani | Department of Surgery, National Center for Global Health and Medicine |
| Author | Yoshimasa Gohda | Department of Surgery, National Center for Global Health and Medicine |
| Author | Yuzo Nagai | Department of Surgery, National Center for Global Health and Medicine |
| Author | Katsuya Deguchi | Department of Surgery, National Center for Global Health and Medicine |
| Author | Tomomichi Kiyomatsu | Department of Surgery, National Center for Global Health and Medicine |
| [ Summary ] | Pseudomyxoma peritonei (PMP) is a rare clinical condition characterized by massive mucinous ascites that usually occurs secondary to a low-grade mucinous neoplasm of the appendix. It is a gradually progressive condition that can be fatal if untreated. Computed tomography (CT) reveals the characteristic distribution of mucinous ascites and is effective for the diagnosis of PMP. Complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard treatment for this condition; however, to date, no randomized control trials have reported this therapy. This treatment strategy is a complex procedure associated with significant morbidity (24 %) and mortality (2 %). Previous studies have shown that CRS+HIPEC performed for PMP was associated with a recurrence rate of 26.4％, a median overall survival of 16.3 years, and a median disease-free survival of 8.2 years. The terminology used to describe PMP and its pathological classification, as well as the optimal surgical procedure and technical modalities of chemotherapy, among other such issues remain controversial. Establishing centralized treatment centers and improving the quality of care for these patients are necessary. | |