Cytoreductive Surgery (CRS)

What is a Cytoreductive Surgery?

Cytoreductive surgery (CRS) is the surgical removal of a tumor with the main purpose of macroscopic excision of as much of the tumor as feasible, where and when it is possible. It is usually given when the cancer is confined within the abdomen such as ovarian cancer, peritoneal carcinomatosis or some gastrointestinal cancers.

Cytoreductive Surgery for Ovarian Cancer

Cytoreductive Surgery is performed for ovarian cancer in: 

• Primary debulking surgery (PDS) – Initial surgery for Stage III/IV ovarian cancer.
• Interval debulking surgery (IDS) – Following several sessions of neoadjuvant chemotherapy to help reduce size of tumor mass.
• Recurrent ovarian cancer – If the cancer emerges again after primary treatment has been done on the patient.

Cytoreductive Surgery HIPEC

Cytoreductive surgery HIPEC is a newly developed technique for treating cancers that have reached the peritoneal cavity lining of the abdomen. HIPEC augments CRS tumor removal by heating chemotherapy to optimally eradicate all the residual cancerous cells to enhance survival rates and avert recurrence.

Cytoreductive with HIPEC Surgery

Surgical Exploration: The surgical intervention involves the making of an abdominal incision, that is, open surgery to determine the level of intraperitoneal spread.

Tumor Removal (Cytoreduction/Debulking): This involves the excision of macroscopic tumor mass by performing the following operations; peritoneectomy, resection of any affected organ including omentum, intestines, bowels, spleen, partial hepatectomy for liver malignancy and hysterectomy in case of ovarian cancer.

Hyperthermic Intraperitoneal Chemotherapy (HIPEC): The chemotherapy solution is heated and circulated in the abdominal cavity for about 60 to 90 minutes with aim to eliminate remaining cancer cells, then the region is rinsed and fluid is drained out.

Abdominal Closure: After the tumor has been removed and HIPEC has been performed, the surgeon makes the necessary closures of the abdominal incision with sutures or staples, and may use drains and catheters to reduce the chances of infection.

Need for Cytoreductive Surgery

CRS aims at decreasing the tumor volume so other treatment modalities like chemotherapy or immunotherapy can be more effective. Physicians performing CRS provide multiple benefits to patients that include increased rate of survival and better quality life since all the apparent cancerous tissues are eradicated.

Symptoms leading to Cytoreductive Surgery

The use of CRS is justified when the cancer has metastasized within the peritoneal space and is producing symptoms. The following are some of the signs wherein a patient may require CRS:

• Abdominal Pain and Discomfort
• Abdominal Swelling and Bloating (Ascites)
• Bowel Obstruction or Changes in Bowel Habits
• Unexplained Weight Loss
• Loss of Appetite and Early Satiety
• Fatigue and Weakness
• Tumor-Related Complications

Cytoreductive Surgery Risks

Cytoreductive surgery (CRS) is a large operation and is associated with several risks and side effects. The failure and its probabilities stem from the general health condition of the patient, type of cancer, and the surgery performed. The following are some of the factors that help in increasing the chances of getting affected by CRS:

• Bleeding (Hemorrhage)
• Infection
• Organ Injury
• Blood Clots
• Bowel Obstruction or Leakage
• Delayed Wound Healing
• Respiratory Issues
• Cardiac Complications
• Kidney Dysfunction
• Nutritional Deficiencies
• Recurrent Cancer
• Quality of Life Impact

Causes leading to Cytoreductive Surgery

CRS is carried out mostly in conditions where the cancer cells have migrated to the peritoneal cavity and require to be surgically removed for better prognostic results. There are several factors that have been established to be leading to CRS, they include:

• Peritoneal Metastasis (Cancer Spread in the Abdomen)
• Pseudomyxoma Peritonei (PMP)
• Peritoneal Mesothelioma
• Recurrent or Chemotherapy-Resistant Cancer

Facilities and Services offered to International Patients for Cytoreductive Surgery

The services that international patients are offered include medical visa support, accommodation support, travel to and from the hospital/clinic, interpreter services, care coordination, financial aid, and follow-up care. These services make such a process easy and painless, enhance the communication process, and give clear information on costing and the planning of the treatment process. India also hosts numerous facilities for CRS treatment and has qualified experts who are equally comparable to those in the developed countries, yet much cheaper. These are the major source countries of these patients, with the objective of getting surgeries that are not easily accessible in their countries of residence that includes; Bangladesh, Iraq, Afghanistan, and Africa.

Cytoreductive Surgery Process

Pre-Treatment for Cytoreductive Surgery

Before undergoing CRS procedure, patients must be assessed and prepared prior to the surgery to have the strongest chance on coming out successful from the operation.

• Physical Examination
• Medical Evaluation
• Nutritional Optimization
• Stopping Certain Medications
• Infection Prevention
• Preoperative Fitness Assessment

Diagnostic Tests for Cytoreductive Surgery

Several tests have to be carried out for staging, general health, and to determine the possibility of this surgery and if so – the extent, before CRS is conducted. These tests aid the doctors to decide whether the patient is suitable for CRS and the methods to be taken to employ.

• CT Scan
• MRI
• PET Scan
• Ultrasound
• X-Ray
• Blood Tests
• Biopsy
• Functional Tests

Cytoreductive Surgery Steps

• Surgical Exploration: The surgical intervention involves the making of an abdominal incision, that is, open surgery to determine the level of intraperitoneal spread.
• Tumor Removal (Cytoreduction/Debulking): This involves the excision of macroscopic tumor mass by performing the following operations; peritoneectomy, resection of any affected organ including omentum, intestines, bowels, spleen, partial hepatectomy for liver malignancy and hysterectomy in case of ovarian cancer.
• Abdominal Closure: After the tumor has been removed and HIPEC has been performed, the surgeon makes the necessary closures of the abdominal incision with sutures or staples, and may use drains and catheters to reduce the chances of infection.

Post-Treatment for Cytoreductive Surgery

After CRS, patients may need to stay in the hospital due to the invasive nature of the surgery, need to feed, regain strength and mobility, and coordination with their medical practitioners. Recovery is defined by the general health, the position of the cancer, and the nature of HIPEC procedure done.

Cytoreductive Surgery Success Rate

From the outcomes of this study, it was apparent that the success of Cytoreductive Surgery (CRS) is determined by many factors such as the type of cancer, the stage of cancer, extent of the tumor resection, as well as Hyperthermic Intraperitoneal Chemotherapy (HIPEC). The successful CRS with a survival rate of 40–80% for 5 years depending on cancer type and tumor burden.

Best Hospitals for Cytoreductive Surgery

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket
• Apollo Hospital, New Delhi

Best Doctors for Cytoreductive Surgery

• Dr. Rupinder Sekhon
• Dr. Ashok Kumar Vaid
• Dr. Vinod Raina
• Dr. Harit Chaturvedi
• Dr. Ruqaya Ahmad Mir

Conclusion

Cytoreductive Surgery is a rather complex and highly effective treatment method for peritoneal malignancies that increases survival and improves the patients’ quality of life when HIPEC is applied in combination with CRS. This procedure comes with an overall success rate of 50-70% in selected patients, with 5 years survival rate of 40-80% depending with the cancer type and tumor load. The highest QoL is observed when gross total resection is attained, and the surgery is done at cancer hospitals. Again, due to the chances of getting infection or bowel obstruction, CRS turned out to be invaluable in eradicating cancers for advanced abdomen as it helps to elongate life and decrease frequency of relapse.

Why Choose Get Well Go for Cytoreductive Surgery?

Opting Get Well Go for Cytoreductive Surgery has a number of benefits because this health-care center is patient-oriented and experienced in managing complicated diseases. Here’s why it might be an excellent choice for cytoreductive surgery:

• Expert Medical Team
• Advanced Surgical Technology
• Language Support
• Travel Assistance
• Accommodation Support
• Visa Assistance

FAQ

1. What is Cytoreductive Surgery (CRS)?

• CRS is a highly technical to remove tumors from the peritoneal lining of the abdominal cavity which is also known as Cytoreductive surgery. It is frequently used with HIPEC in the treatment of managing microscopic cancer cells that are left behind.

2. What is the recovery period for CRS?

• Hospital stay: 10-14 days
• Full recovery: 2-3 months

There should be follow-ups and scans required long-term for the patient.

3. What are the benefits of CRS?

• Improved Survival Rates
• Reduced Cancer Recurrence
• Enhanced Quality of Life
• Targeted Treatment with Fewer Side Effects
• Increased Chance of Long-Term Remission
• Alternative to Palliative Care

4. How to book a consultation with GetWellGo for Cytoreductive Surgery?

• Contact no: +91-9289678787
• Email: care@getwellgo.com
• Webpage link: https://getwellgo.com/