SRS383 - Systematic review of laparoscopic cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal metastases

Abstract Introduction Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) is an established treatment for selected patients with peritoneal metastases. Traditionally performed via laparotomy, recent advances in minimally invasive techniques have enabled a laparoscopic approach (L-CRS + HIPEC). This systematic review evaluates the current literature on L-CRS + HIPEC, focusing on perioperative morbidity, postoperative recovery, oncologic outcomes, and time to chemotherapy (TTC), to determine its feasibility and effectiveness. Methods A systematic search of PubMed and Web of Science (Nov–Dec 2024) identified studies reporting outcomes of L-CRS + HIPEC in adults with peritoneal malignancyy. Both comparative and non-comparative studies were included. Outcomes of interest were morbidity, length of stay, TTC, and long-term oncologic endpoints. Results Nine studies comprising 482 patients were included. L-CRS + HIPEC was associated with reduced blood loss, shorter hospital stays, and earlier TTC. Rates of complete cytoreduction (CC0–1) were comparable to, or higher than, those reported for open CRS + HIPEC. In comparative studies, no significant differences were observed in recurrence, disease-free survival, or overall survival, though sample sizes and follow-up durations were limited. Conclusions L-CRS + HIPEC appears safe and feasible in selected patients, with potential advantages in perioperative outcomes and earlier chemotherapy resumption. Reported oncologic outcomes are comparable to open surgery, though evidence remains limited by small samples, retrospective designs, and short follow-up. Larger prospective trials are required to validate findings and refine patient selection before L-CRS + HIPEC can be confidently recommended as a standard approach.