Peritonectomy (Sugarbaker Operation)
Sugarbaker operation is a cyto-reductive surgery, or debulking operation, that aims to remove as much as gross tumour as possible.
Patients with pseudomyxoma peritoneii due to appendix or ovary cancers may be suitable for the operation. The objective of this operation is to remove all visible cancer in the abdomen, including the primary cancer.
During the operation, the surgeon removes the peritoneum which lines the abdominal wall. In addition, other abdominal organs such as the spleen, part of the large or small bowel, the gallbladder and omentum may be removed if there are tumours adherent to these organs. The womb and ovaries may also be removed in women because cancer cells often sequester around these organs.
Stoma or colostomy may be performed in this operation, however, majority of stomas are temporary and after six months or so, the stoma will be reversed.
While the patient is still under anaesthesia, a heated chemotherapy drug is infused into the abdomen. The chemotherapy drug will help to kill any invisible cancer cells. The chemotherapy is administered as heated intraabdominal chemotherapy, also known as Hyperthermic Intra-Peritoneal Chemotherapy (HIPEC).
The common complications of this major operation are:
- Leak at the site where the intestine or bowel are connected, following removal of a segment of the bowel
- Wound infection
- Small bowel obstruction