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Multimodality treatment of peritoneal carcinomatosis with cytoreductive surgery and HIPEC (372906) | University Hospital Halle (Saale) - 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. After that, the surgeon removes the catheters and sutures the incision of the anterior abdominal wall.<\/p>\n\n<p style=\"text-align: justify;\"><strong>After the completion of the operation<\/strong>, 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.<\/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 Halle (Saale)

Halle, Germany
Program id # 372906
Doctor photo
Prof. Dr. med. Jörg Kleeff
Department of General, Abdominal, Vascular and Endocrine Surgery
Specialized in: general, abdominal, vascular, endocrine 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

The Department of General, Abdominal, Vascular and Endocrine Surgery at the University Hospital Halle (Saale) offers the full range of medical services in these fields. The department specializes in the surgical treatment of gastrointestinal cancers (surgical treatment of pancreatic, liver, stomach, esophageal and colon malignancies), hernia repair, treatment of gastrointestinal inflammatory diseases, endocrine surgery and surgical correction of vascular diseases and defects. The treatment of patients is carried out in close cooperation with the experts from related fields, particularly, with oncologists, gastroenterologists, radiologists, angiologists, etc. The Chief Physician of the department is Prof. Dr. med. Jörg Kleeff.

The department widely practices the very latest treatment methods. For example, the department has vast experience in the use of hyperthermic intraperitoneal chemotherapy (HIPEC), sparing interventional procedures, minimally invasive interventions, including robotic surgery (da Vinci Si®). With appropriate indications, the outpatient interventions can be performed as well, for example, hernia repair, lymph node removal, soft tissue tumor removal and many others.

The priority of each employee in the department is to provide the patient with comprehensive treatment at the highest level of modern university medicine. At the same time, doctors also devote much time to personal consultations with patients, which helps to establish trust and  cheer up the patient for a positive therapy outcome.

The main clinical focuses of the department include:

  • Diagnostics and surgical treatment of oncological diseases of the gastrointestinal tract (certification of the German Cancer Society)
    • Bowel cancer
    • Pancreas cancer
    • Stomach and esophageal cancer
    • Liver and bile duct cancer
    • Peritoneal cancer
    • Endocrine tumors
  • Vascular surgery
    • Open surgery and stent implantation in aortic diseases, aneurysms, dissection and occlusions
    • Surgical treatment or stent implantation in carotid stenosis (stroke prevention)
    • Treatment of stenosis and occlusion of the lower limb vessels (occlusive peripheral arterial disease, intermittent claudication)
    • Pain therapy with spinal cord stimulation in occlusive peripheral arterial disease
    • Dialysis access formation (including revision procedures)
    • Open and closed interventions in dialysis fistulas, defects after continuous use of catheters, etc.
    • Correction of congenital arteriovenous malformations
    • Treatment of venous diseases (varicose veins, thrombosis)
    • Basic and intraoperative diagnostics using dopplerography and duplex ultrasonography, angiography (CO2) with or without a contrast agent, 3D angiography
  • Endocrine surgery
    • Surgery in benign endocrine diseases
      • Goiter
      • Thyroid autonomy and hyperfunction
      • Thyroiditis
    • Surgeries for endocrine malignancies
      • Differentiated tumors (papillary, follicular thyroid cancer)
      • Medullary thyroid cancer
      • Undifferentiated cancer
      • Recurrent thyroid tumors
      • Lymph node metastases
      • Hereditary thyroid cancer (medullary thyroid cancer in men)
    • Adrenal surgery
      • Adrenal hyperfunction
      • Enlarged adrenal glands
      • Adrenal metastases
      • Rare adrenal malignancies
    • Parathyroid surgery
      • Hyperparathyroidism in parathyroid adenoma
      • Parathyroid hyperfunction in dialysis patients
      • Rare malignant changes in the parathyroid glands
    • Neuroendocrine tumor surgery
  • Hernia repair
    • Transabdominal preperitoneal hernioplasty
    • Total extra-abdominal hernioplasty
    • Open operations according to Lichtenstein and Shouldice techniques
    • IPOM plastic surgery using special meshes
    • Ramirez operation
  • Liver and biliary tract surgery, including minimally invasive interventions
  • Robotic surgery (da Vinci Si®)
    • Esophageal and stomach surgery
    • Liver, biliary tract and gallbladder surgery
    • Pancreatic surgery
    • Colon and small intestine surgery
    • Abdominal wall surgery
  • Outpatient surgery
    • Implantation of port systems for chemotherapy or artificial nutrition
    • Open or minimally invasive interventions for the treatment of inguinal hernia
    • Umbilical hernia repair
    • Lymph node removal
    • Soft tissue tumor removal
    • Anal and rectal interventions(for example, in hemorrhoids)
    • Pilonidal cyst sanitation
  • Other diagnostic and therapeutic options

Curriculum vitae

Education

  • 1990 - 1992 Faculty of Medicine at the Eberhard Karls University of Tübingen.
  • 1992 - 1996 Faculty of Medicine at Ludwig Maximilian University of Munich.
  • 1997 PhD thesis, Ludwig Maximilian University of Munich. Subject: "Diagnostic Methods and Epidemiology of HTLV-I and II in Germany".
  • 2005 Habilitation, Ruprecht Karl University Heidelberg. Subject: "Mechanisms of pancreatic carcinoma aggression at the molecular level – the TGF-beta signaling pathway".
  • 2010 Extraordinary Professor, Technical University of Munich.

Internships Abroad

  • 1994 University of Washington, Laboratory of Murray Korc, Seattle, USA.
  • 1995 Harvard University, Boston, USA.
  • 1996 Inselspital, University of Bern, Switzerland.
  • 1996 University of Toronto, Canada.

Professional Training and Qualifications

  • Board certification in General, Abdominal and Special Abdominal Surgery.
  • 1999 - 2005 Assistant Physician, Department of Abdominal and Transplant Surgery, Inselspital, University of Bern, Switzerland, as well as Department of General and Abdominal Surgery, Trauma Surgery, University Hospital Heidelberg.
  • 2005 - 2008 Senior Physician, Department of General, Abdominal and Trauma Surgery, University Hospital Heidelberg as well as Department of Surgery at the University Hospital rechts der Isar Munich.
  • 2009 - 2010 Managing Senior Physician, Department of Surgery at the University Hospital rechts der Isar Munich.
  • 2010 - 2015 Leading Senior Physician, Department of Surgery at the University Hospital rechts der Isar Munich.
  • 2013 - 2014 Acting Head, Department of Surgery at the University Hospital rechts der Isar Munich.
  • 2015 - 2016 Consultant in Hepatobiliary, Pancreatic and General Surgery, Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK.
  • Since 2015 Professor, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, UK.
  • Since 2017 Professor for Abdominal Surgery and Head of the Department of General, Abdominal, Vascular and Endocrine Surgery, University Hospital Halle (Saale).
  • Since 2017 Chief Physician, Department of General, Abdominal and Vascular Surgery, BG Kliniken Bergmannstrost Halle.

Additional Qualifications

  • 2011 Master of Health Business Administration (MHBA), Friedrich-Alexander University Erlangen-Nuremberg.

Memberships in Scientific Societies

  • American Gastroenterological Association (AGA).
  • American Pancreatic Association (APA).
  • Asian-Pacific Hepato-Pancreato-Biliary Association (A-PHPBA).
  • Professional Association of German Surgeons (BDC).
  • British Medical Association (BMA).
  • German Society of General and Abdominal Surgery (DGAV).
  • German Society of Surgery.
  • German Society for Digestive and Metabolic Diseases (DGVS).
  • German Pancreatic Club (DPC).
  • European Digestive Surgery (EDS).
  • European-African Hepato-Pancreato-Biliary Association (E.AHPBA).
  • European Neuroendocrine Tumor Society (ENETS).
  • European Pancreatic Club (EPC).
  • European Surgical Association (ESA).
  • Bavarian Society of Gastroenterology.
  • International Association of Pancreatology (IAP).
  • International Hepato-Pancreato-Biliary Association (IHPBA).
  • Society for Surgery of the Alimentary Tract (SSAT).
  • Association of Bavarian Surgeons.

Awards and Titles

  • Honorary Professor of R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences of Ukraine.
  • Adjunct Associate Clinical Professor, Tufts University School of Medicine, Boston, USA.
  • Fellow of the American Gastroenterological Association (AGAF).
  • Fellow of the American College of Surgeons (FACS).
  • Fellow of the Royal College of Surgeons (FRCS).

Photo of the doctor: (c) Universitätsklinikum Halle (Saale) 


About hospital

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities!

The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a specialized medical facility for the treatment of very severe and rare diseases and injuries. It provides medical care for patients of all age groups in accordance with the very latest scientific achievements. It is worth noting that the hospital is characterized by its successful research activities, especially in the field of cardiovascular diseases and oncopathology. The specialists of these fields have made a significant contribution to the development of new diagnostic methods and therapeutic approaches.

The hospital diagnoses and treats more than 40,000 inpatients and about 120,000 outpatients every year. Such a large number of patients indicates the reliability and effectiveness of medical services.

Some structural units of the hospital deserve special attention. For example, the Central Department of Emergency Medical Care (the largest in Saxony-Anhalt), modern dental rooms, the Perinatal Center and the Transplant Center with a history of more than 40 years.

Thanks to the use of the cutting-edge medical technology and the availability of advanced equipment, many operations and procedures, which previously could entail a lot of risks and consequences, are currently performed in the hospital with the help of sparing techniques. In this context, it is worth noting hybrid heart interventions, robotic interventions in urology (da Vinci surgical system), etc.

In addition, the key to successful clinical practice is the availability in the hospital of experienced and competent medical staff. The total number of medical staff includes more than 4,000 medical employees. Many doctors are known far beyond the borders of Germany, they regularly carry out significant researches, which allow them to develop modern medicine. In addition, the hospital specializes in training of medical students, therefore the qualified doctors and professors are willing to pass on their experience to the younger generation.

Photo: (c) depositphotos

Accommodation in hospital

Patients rooms

The patients of the University Hospital Halle (Saale) live in comfortable single, double and triple patient rooms made in a modern design. All patient rooms are equipped with an ensuite bath with toilet and shower. The standard room includes a comfortable, automatically adjustable bed, a bedside table, a wardrobe, a table and chairs for receiving visitors and a TV. There is access to Wi-Fi. For security reasons, in some places, including in Intensive Care Units, it is forbidden to use laptops and mobile phones. In addition, the hospital offers enhanced-comfort patient rooms.

Meals and Menus

The patient and his accompanying person have a daily choice of three menus. If for any reason you do not eat all the food, you will be offered an individual menu. Please inform the medical staff about your dietary preferences prior to the treatment. Children are offered a special menu with healthy and tasty dishes, rich in nutrients necessary for the growing body.

Further details

Standard rooms include:

Toilet
Shower
Wi-Fi
TV

Religion

Religious services are available upon request.

Accompanying person

During the inpatient program, an accompanying person may stay with you in a patient room or hotel of your choice.

Hotel

During the outpatient program, you may stay in a hotel of your choice. Managers will help you choose the most suitable options.