ABSTRACT
Aim COVID-19 has instigated rapid alterations in surgical care. Performing CRS-HIPEC for peritoneal metastases during such challenging times has required several perioperative changes. We report our early experience of undertaking CRS-HIPEC during the COVID-19 pandemic. Methods A retrospective review of all patients undergoing CRS-HIPEC was conducted (1st April/20 – 28th May/20). Data was retrieved from a prospectively maintained peritoneal malignancy database. Results Twelve patients (M:F, 5:7;median, 56yr (26-70yr)) underwent CRS-HIPEC. Five patients had peritoneal metastases of colorectal origin, with a median peritoneal-carcinomatosis-index (PCI) of 12, while four patients had advanced pseudomyxoma peritonei (median, PCI 23). Patients were pre-operatively assessed for SARS-CoV-2. Operating theatres (OT) with laminar-air-flow-systems and high-efficiency-particulate-air-filters were utilized. Essential personnel were permitted through a one-way entry/exit pathway. Double plume extractors were used to remove surgical smoke throughout the operation. HIPEC was conducted using the closed rather than open abdomen technique. Patients were transferred via a modified critical care pathway to HDU. Early results have identified no significant COVID-related complications. Conclusion Initial experience of surgery for peritoneal malignancy in the COVID-19 era is encouraging. We will continue to carefully audit our perioperative outcomes as our experience builds.