procedure after debulking before closure

[SimplyStar]

I have been wondering for some time about what they "washed" my daughters abdomen out with after the removal of the cancer, surgeon told her he "washed" it out 3 times.  Wouldn't this be an excellent time to get those loose cells that cause the recurrances? Leslee does not know what was used and we have no way of finding out just now. There are so many "things" that are supposed to kill cancer cells on contact like O2, ginger, heat, etc., all of which I would think would not be dangerous to use before closing.  Give me your thoughts on this please. Back in my early days of nursing I remember cancer patients incisions being left open and we irrigated them several times daily with what I think was potassium permanganate solution. The wound itself was covered with moist sterile dressings and after several weeks the incision was closed. I have no way of knowing if this worked or not, as they were all discharged and I never came in contact with them again.

[SimplyStar]

To me it just makes sense that even the best surgeon cannot get all the loose cells and if a solution of cancer cell killers can be used to "wash" out the cavity then it just might prevent some of these recurrances.  I intend to ask some questions on this and try to get a feel for what possible research has or is being tried .

[orangefuzzball]

Hi Star,

The abdominal cavity is normally washed with saline.

I had a heated (42 c) chemotherapy solution directly into my abdominal cavity for 90 minutes (HIPEC/IPHC) during surgery, prior to being 'reconnected and sewn up' after radical cytoreductive surgery. Some chemo solutions are absorbed extremely well at 42 degrees and effective to approx 3mm, the heat also helps kill the cancer cells. http://www.pmpawareness.org/ has more info about HIPEC/IPHC.

This is the gold standard treatment for appendix cancer and pseudomyxoma, however I do know that Demasso had this done for ovarian cancer and there are some centres in the US and Europe that are starting doing it for bowel and ovarian cancer with very good results. Dr Levine at Wake Forest Baptist Medical Centre does the surgery for bowel cancer with IP spread and I think that he has also done some ovarian patients too. In the UK HIPEC is licenced for appendix cancer only in just 2 centres, in the US it's a case of fighting the insurance to get the treatment for appendix as it's deemed experimental (appendix cancer is very rare and trials are in very small numbers, 10's rather than 1000's) whether it's possible to actually get cover for ovarian if it's not on an actual trial I don't know. As a side note the surgeon has to be a recognised and experienced specialist in the 'Sugarbaker Technique' and HIPEC, it isn't surgery that a normal gynae/onc can do (I had 6 consultant surgeons in theatre, ranging from bowel, liver & gynae to cardio-thorasic, all regional specialists)

The surgery is huge, literally everything that is dispensible goes and all surfaces that can't be removed are stripped, all visible tumour has to be removed otherwise the HIPEC isn't effective. I've just had the first of two 13.5 hours surgeries, but to be honest it's a small price to pay if it works.

Might be worth looking into further.

Lisa

[EchoUK]

Saline solution on me too!

[Kimchi]

When I had my infection (in my leg) washed, my doctor told me he had to use 15 bags of saline solution.  As for my hysto, I was told it was saline as well.

[SimplyStar]

I figured it was a saline solution, but am just wondering if any one in here has ever had or heard of a different technique being used. Like I said,  that mention of open incisions was 50 years ago. The surgeon did tell us that in surgery for OVCA, he changes gloves 3 to 4 times,  and uses 3 instrument trays .  I just about drove him nuts with all my questions, now that I know more,  I am sure I would have asked many more.  I wanted so bad to be in the ORT while this was going on,  but they wouldn't even let me watch from the overhead room.

[rmarie]

I am with Dian, it was probably a saline lavage.  The ginger is under study, and it was done with mouse cancer cells.  Wounds today, are only left open, if they are contaminated, then we pack them with a wet to dry dressing 3 times a day, and it is for any patient with a dirty wound.  Hope this helps.

[dian07]

I just figured the lavage was done with saline.....nothing else was indicated....cells were found, thus the 6 carbo/taxol.....my first 6 month check up is in June.....the 3 month checks were getting to be like a security blanket for me......oh well.....
Peace.
dian