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Multimodality treatment of peritoneal carcinomatosis with cytoreductive surgery and HIPEC (368851) | University Hospital Essen - BookingHealth
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After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan and tomography of the abdominal organs. Based on the results of the examination, the physician will choose the surgical technique and the type of anesthesia. After that, preparation according to the preoperative standard will start.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Cytoreductive surgery<\/strong> begins with general anesthesia. The intervention is performed as open surgery, i.e. through the incision in the anterior abdominal wall, so that the surgeon can carefully examine the peritoneum and the surface of the abdominal organs. The surgeon removes affected by the malignant process areas of the small intestine and peritoneum, metastases in other internal organs. This stage of the operation can take several hours, since the overall effectiveness of the treatment depends on the completeness of the malignant tissues removal.<\/p>\n\n<p style=\"text-align: justify;\">At the next stage of the operation, the surgeon inserts several catheters into the abdominal cavity. Through the catheters, a heated solution of a chemotherapy drug is pumped inside. The special system maintains the required temperature (42-43 degrees Celsius), pressure and circulation rate of the medicinal solution. The solution mechanically flushes out blood clots and remnants of malignant tissues, and a heated chemotherapy drug destroys micrometastases in internal organs and lymph nodes (micrometastases can&rsquo;t be detected by the naked eye).<\/p>\n\n<p style=\"text-align: justify;\">After 1-1.5 hours, the chemotherapy drug is removed from the abdominal cavity and the abdominal cavity is washed with saline. 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The whole treatment takes 10-12 days on average.<\/p>\n\n<p style=\"text-align: justify;\">Finally, the attending physician will evaluate the results of <strong>control examinations<\/strong>, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">MRI\/CT scan (not older than 3 months)<\/li>\n\t<li style=\"text-align: justify;\">Biopsy results (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>clinical history taking<\/li>\n\t<li>review of medical records<\/li>\n\t<li>physical examination<\/li>\n\t<li>laboratory tests:\n\t<ul>\n\t\t<li>complete blood count<\/li>\n\t\t<li>general urine analysis<\/li>\n\t\t<li>biochemical analysis of blood<\/li>\n\t\t<li>TSH-basal, fT3, fT4<\/li>\n\t\t<li>tumor markers&nbsp;<\/li>\n\t\t<li>inflammation indicators (CRP, ESR)<\/li>\n\t\t<li>indicators of blood coagulation<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>abdominal ultrasound scan<\/li>\n\t<li>CT\/MRI or PET-CT scan of&nbsp;abdomen<\/li>\n\t<li>preoperative care<\/li>\n\t<li>cytoreductive surgery to remove visible tumors<br \/>\n\twithin the abdomen and HIPEC<\/li>\n\t<li>histological&nbsp;and immunohistochemical<br \/>\n\texamination of&nbsp;removed&nbsp;tissues<\/li>\n\t<li>symptomatic treatment<\/li>\n\t<li>cost of essential medicines<\/li>\n\t<li>nursing services<\/li>\n\t<li>full hospital accommodation<\/li>\n\t<li>accommodation in a 2-bed room<\/li>\n\t<li>elaboration of further recommendations<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align: justify;\"><strong>During the first visit<\/strong>, the physician will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan and tomography of the abdominal organs. Based on the results of the examination, the physician will choose the surgical technique and the type of anesthesia. After that, preparation according to the preoperative standard will start.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Cytoreductive surgery<\/strong> begins with general anesthesia. The intervention is performed as open surgery, i.e. through the incision in the anterior abdominal wall, so that the surgeon can carefully examine the peritoneum and the surface of the abdominal organs. The surgeon removes affected by the malignant process areas of the small intestine and peritoneum, metastases in other internal organs. This stage of the operation can take several hours, since the overall effectiveness of the treatment depends on the completeness of the malignant tissues removal.<\/p>\n\n<p style=\"text-align: justify;\">At the next stage of the operation, the surgeon inserts several catheters into the abdominal cavity. Through the catheters, a heated solution of a chemotherapy drug is pumped inside. The special system maintains the required temperature (42-43 degrees Celsius), pressure and circulation rate of the medicinal solution. The solution mechanically flushes out blood clots and remnants of malignant tissues, and a heated chemotherapy drug destroys micrometastases in internal organs and lymph nodes (micrometastases can&rsquo;t be detected by the naked eye).<\/p>\n\n<p style=\"text-align: justify;\">After 1-1.5 hours, the chemotherapy drug is removed from the abdominal cavity and the abdominal cavity is washed with saline. 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Multimodality treatment of peritoneal carcinomatosis with cytoreductive surgery and HIPEC

University Hospital Essen

Essen, Germany
Program id # 368851
Doctor photo
Prof. Dr. med. Andreas Paul
Department of General, Abdominal and Transplant Surgery
Specialized in: general, abdominal, transplant surgery

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • general urine analysis
    • biochemical analysis of blood
    • TSH-basal, fT3, fT4
    • tumor markers 
    • inflammation indicators (CRP, ESR)
    • indicators of blood coagulation
  • abdominal ultrasound scan
  • CT/MRI or PET-CT scan of abdomen
  • preoperative care
  • cytoreductive surgery to remove visible tumors
    within the abdomen and HIPEC
  • histological and immunohistochemical
    examination of removed tissues
  • symptomatic treatment
  • cost of essential medicines
  • nursing services
  • full hospital accommodation
  • accommodation in a 2-bed room
  • elaboration of further recommendations

How program is carried out

During the first visit, the physician will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan and tomography of the abdominal organs. Based on the results of the examination, the physician will choose the surgical technique and the type of anesthesia. After that, preparation according to the preoperative standard will start.

Cytoreductive surgery begins with general anesthesia. The intervention is performed as open surgery, i.e. through the incision in the anterior abdominal wall, so that the surgeon can carefully examine the peritoneum and the surface of the abdominal organs. The surgeon removes affected by the malignant process areas of the small intestine and peritoneum, metastases in other internal organs. This stage of the operation can take several hours, since the overall effectiveness of the treatment depends on the completeness of the malignant tissues removal.

At the next stage of the operation, the surgeon inserts several catheters into the abdominal cavity. Through the catheters, a heated solution of a chemotherapy drug is pumped inside. The special system maintains the required temperature (42-43 degrees Celsius), pressure and circulation rate of the medicinal solution. The solution mechanically flushes out blood clots and remnants of malignant tissues, and a heated chemotherapy drug destroys micrometastases in internal organs and lymph nodes (micrometastases can’t be detected by the naked eye).

After 1-1.5 hours, the chemotherapy drug is removed from the abdominal cavity and the abdominal cavity is washed with saline. After that, the surgeon removes the catheters and sutures the incision of the anterior abdominal wall.

After the completion of the operation, you will be transferred to the ward of the intensive care unit, under the round-the-clock supervision of doctors and nurses. In 1-3 days after the operation, your drains will be removed and you will be transferred to a regular ward for further recovery. The whole treatment takes 10-12 days on average.

Finally, the attending physician will evaluate the results of control examinations, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.

Required documents

  • Medical records
  • MRI/CT scan (not older than 3 months)
  • Biopsy results (if available)

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About the department

According to the Focus magazine, the Department of General, Abdominal and Transplant Surgery at the University Hospital Essen ranks among the top German departments specializing in bowel cancer treatment!

The department offers the full range of services in these medical fields and enjoys the reputation of one of the leading Centers for Liver and Kidney Transplants in Europe. The priority focus of the department’s activities is oncology. The doctors of the department have high competence and rich experience in the treatment of oncopathology, including particularly complex forms. The department widely practices all modern surgical techniques. Preference is always given to sparing minimally invasive techniques that provide minimal pain, risks and speedy recovery of the patient. The department is headed by Prof. Dr. med. Andreas Paul.

Of particular interest to the department’s specialists is the treatment of pancreatic, esophageal and intestinal cancer, as well as the surgical treatment of benign diseases of all digestive organs. The department also performs a large number of operations on the endocrine organs, in particular on the thyroid gland and parathyroid glands. In the treatment of patients with endocrine pathologies, there is close cooperation with the experts in the field of endocrinology, nuclear medicine, nephrology, radiation therapy, radiology, ophthalmology, which guarantees a comprehensive approach to treatment and the most effective result.

It is worth noting that the department is equipped with the advanced surgical equipment for minimally invasive interventions. The standard treatment methods include laparoscopic gallbladder removal, liver resection, surgical treatment of gastroesophageal reflux disease, cecal removal, surgical treatment of the colon, etc.

Also, the department’s priorities include transplant surgery. The surgeons specialize in kidney, liver, and pancreas transplantation. For all the time of clinical practice, there were performed more than 3,000 kidney transplants and 1,800 liver transplants. The first liver transplantation was performed here in 1987, and the first kidney transplant in 1972. Since then, the department holds leading positions at the national and international levels. Special attention is paid to a live donor kidney transplant and a cross-donation program. The intensive care unit, which specializes in caring for patients after abdominal interventions, provides optimal treatment of very severe surgical cases, as well as monitoring of patients with liver failure and patients after organ transplants.

The service range of the department includes:

  • Surgical treatment of esophageal and stomach diseases
    • Benign diseases
      • Gastroesophageal reflux disease (reflux esophagitis, Barrett's esophagus)
      • Diverticulum (Zenker's diverticulum, epiphrenic diverticulum)
      • Esophageal achalasia
      • Benign tumors
      • Traumatic injuries (for example, perforation)
    • Malignant diseases
      • Adenocarcinoma
      • Squamous cell carcinoma
      • Gastrointestinal stromal tumors
    • Diagnostic services
      • pH metry
      • Manometry
      • Video-esophagogram
      • Esophagogastroduodenoscopy with biopsy
      • Endosonography
      • Computed tomography
      • Blood test for tumor markers
      • Blood test for molecular genetic markers
    • Therapeutic services
      • Laparoscopic Nissen fundoplication in gastroesophageal reflux disease
      • Endoscopic resection of the mucous membrane in Barrett's esophagus with severe dysplasia
      • Laparoscopic Heller myotomy in achalasia
      • Endoscopic diverticulum removal
      • Limited esophageal resection in benign tumors or traumatic injuries of the esophagus
      • Stage-adapted treatment of esophageal cancer
      • Endoscopic resection of the mucous membrane
      • Esophagectomy with lymphadenectomy (abdominothoracic or transhiatal) without neoadjuvant therapy
      • Neoadjuvant therapy and esophagectomy with lymphadenectomy (abdominothoracic or transhiatal)
      • Gastrectomy with lymphadenectomy
      • Palliative care
  • Surgical treatment of diseases of the liver, bile duct and pancreas
    • Benign and malignant liver tumors
    • Liver cysts
    • Biliary tract occlusion
    • Chronic pancreatitis
    • Malignant pancreatic tumors
  • Surgical treatment of endocrine diseases
    • Thyroid resection
    • Total thyroid resection
    • Central lymphadenectomy
    • Lateral and mediastinal lymphadenectomy (functional neck dissection)
    • Extended neck resection with reconstruction of the vessels, esophagus and trachea
    • Secondary interventions, for example, in case of tumor recurrence
    • Resection of the retrosternal thyroid gland
    • Video-assisted, minimally invasive thyroid removal
  • Surgical treatment of diseases of the small and large intestine, anal canal
    • Diagnostic services
      • Diagnostic examination of the rectum and anal canal in benign and malignant diseases (proctoscopy, rectoscopy, 3D endosonography)
      • Staging, therapy control, subsequent monitoring after the treatment of rectal and anal tumors
    • Therapeutic services
      • Minimally invasive surgery
      • Open interventions
  • Minimally invasive surgery
    • Removal of metastases, treatment of spontaneous pneumothorax, thymus removal (lung surgery)
    • Tissue sampling, for example, lymph node tissue sampling to make a diagnosis (mediastinoscopy)
    • Gastric surgery (fundoplication) in g
    • astroesophageal reflux disease
    • Gallbladder removal in case of inflammation, gallbladder stones (standard and single-port technique)
    • Removal of the adrenal glands in benign or malignant tumors
    • Bowel surgery in benign or malignant tumors and diverticula
    • Appendectomy
    • Hernia repair
    • Surgical treatment of liver cysts
    • Implantation of peritoneal dialysis catheters
    • Partial liver resection
    • Kidney donation
    • Obesity surgery
  • Other surgical services

Photo of the doctor: (c) Universitätsklinikum Essen 


About hospital

According to the authoritative Focus magazine the University Hospital Essen ranks among the top German hospitals!

With 27 specialized departments and 24 institutes, the hospital in Germany is a maximum care medical facility. The hospital has 1,300 beds for inpatient treatment. A highly qualified medical team of more than 6,000 employees takes care of the health of patients. All the specialists give preference to an interdisciplinary medical care, which guarantees a comprehensive treatment taking into account the smallest aspects of a particular pathology. The hospital annually diagnoses and treats more than 50,000 inpatients and about 195,000 outpatients, which testifies to the prestige of the medical institution and the highest quality of treatment in Germany.

The hospital presents all the modern medical fields. Nevertheless, special attention should be given to the following major fields of specialization as oncology, transplantology and cardiology, as well as research activities in the field of immunology, infectology and translational examinations of pathologies of the nervous system and behavioral disorders.

Established on the basis of the standard American model of Comprehensive Cancer Centers, the West German Cancer Center (WTZ) in Essen was recognized as the best medical facility of this kind in Germany in 2009. Nowadays, the center holds leading positions both on the national and international medical markets. The basis of its successful clinical practice is the use of very latest treatment methods and an interdisciplinary approach to each clinical case. The West German Organ Transplant Centre (WZO) is also recognized as one of the best in the country and one of the few in Germany, which specializes in the transplantation of all vital organs, such as kidney, liver, pancreas, heart and lungs. Special attention is paid to kidney and liver transplantation.

The hospital in Germany is proud of its high-tech medical equipment, experienced and competent staff, productive research activities, which allow to guarantee the accurate diagnostics and effective treatment, including rare and very complex clinical cases for every patient. Consequently, the hospital is considered a perfect embodiment of high-quality treatment in Germany.

Photo: (c) depositphotos

Accommodation in hospital

Patients rooms

The patients of the University Hospital Essen live in comfortable rooms designed in bright colors. The standard room furnishing includes an automatically adjustable bed, a bedside table, a personal wardrobe, a personal call button with a built-in light panel, a telephone, a TV and a radio. The Internet access is available at an additional cost.

Meals and Menus

The patients of the hospital are offered a daily choice of three menus. The patients are also offered alternative types of menus, if their religion requires the exclusion of certain foods. If you follow a certain diet or suffer from food intolerance, you will be provided with a menu of your choice by discussing it with your attending physician in advance. The hospital also houses a bistro and a cafe, where one can have a tasty snack, enjoy hot and cold drinks.

Further details

Standard rooms include:

Toilet
Shower
TV

Accompanying person

There are a few types of hotels for the accompanying persons, who want to stay near the hospital. The hotel of the Essen University Hospital offers apartments on the first floor of the nursing high-rise building. The DRK nursing also offers single and double rooms.

The hotel in Grugapark is available for the parents, whose children stay in the hospital. The parents of children with cancer can also stay here. Moreover, The Department of Pediatrics offers its rooms for parents.