Vol.:(0123456789) 1 3 Surgical Endoscopy https://doi.org/10.1007/s00464-019-07280-1 Long‑term results of laparoscopic cytoreductive surgery and HIPEC for the curative treatment of low‑grade pseudomyxoma peritonei and multicystic mesothelioma Frederic Mercier 1,2  · Guedj Jeremie 1  · Mohammad Alyami 1,3,4  · Vaudoyer Delphine 1  · Kepenekian Vahan 1,3  · Rousset Pascal 3,5  · Isaac Sylvie 6  · Passot Guillaume 1,3  · Glehen Olivier 1,3 Received: 16 November 2018 / Accepted: 23 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) provide long-term survival for low-grade pseudomyxoma peritonei (PMP) and multicystic peritoneal mesothelioma (MM). Feasibility of lapa- roscopic CRS-HIPEC has been reported for selected patients but data regarding long-term outcomes are missing to assess the oncological interest. This study aimed to report long-term outcomes for low-grade PMP and MM treated by laparoscopic approach. Methods From a prospectively maintained CRS-HIPEC database, all patients who underwent laparoscopic CRS-HIPEC with curative intent were analyzed. Selection criteria for laparoscopic approach were low-grade PMP or MM, with pathological confrmation prior to CRS-HIPEC, ASA 2, age < 75 years, no extrap-eritoneal disease, Peritoneal Cancer Index (PCI) < 10, and a limited history of abdominal surgery. Results Between March 2009 and June 2017, 43 patients were scheduled for laparoscopic CRS and HIPEC. Laparoscopic CRS and HIPEC was completed (LSC) in 32 patients and 11 patients were converted to open surgery (CONV). Median age was 44.5 years (17.13–71.4) in the LSC group and 54.9 years (22.5–70.5) in the CONV group (p = 0.086). Median BMI was not diferent between groups, 21.2 and 23.9 for LSC and CONV groups, respectively (p = 0.267). There were 21 and 11 patients in the LSC group, and 8 and 3 in the CONV group, with PMP and MM, respectively (p = 0.794). Median PCI was 2.5 (0–9) and 7 (1–15) in the LSC and CONV groups, respectively (p = 0.004). There was no diference in the completeness of cytoreduction score (p = 0.256). After a median follow-up of 31.6 months (95% CI 19.3–36.4), 2 patients in the LSC group and 2 patients in the CONV group presented with peritoneal recurrence. Conclusion For selected patients with low aggressive peritoneal disease, laparoscopic CRS-HIPEC provides interesting long-term outcomes. Keywords Peritoneal carcinomatosis · Peritoneal carcinosis · HIPEC · Cytoreductive surgery · Laparoscopic HIPEC · Laparoscopy · Low grade appendicular mucinous neoplasm · Pseudomyxoma peritonei · Multicystic mesothelioma Cytoreductive surgery (CRS) and hyperthermic intraperi- toneal chemotherapy (HIPEC) are the only curative treat- ments for peritoneal surface malignancies and ofer the best outcome for low-grade pseudomyxoma peritonei (Low-grade PMP) and multicystic mesothelioma (MM) [1, 2]. and Other Interventional Techniques * Frederic Mercier frederic.mercier.chum@ssss.gouv.qc.ca 1 Department of Surgical Oncology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France 2 Department of Surgical Oncology, CHUM, Centre Hospitalo-Universitaire de Montreal, 1000 Rue Saint-Denis, H2X0C1 Montreal, QC, Canada 3 EMR 3738, Lyon 1 University, Lyon, France 4 King Salman Scholarship Program, Saudi Arabian Culture Bureau, Paris, France 5 Department of Radiology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France 6 Department of Pathology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France