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John S. Spratt, MD
Louisville, Ky

Arch Surg. 1999;134:550.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The authors provide a modification in technique of hyperthermic peritoneal perfusion for peritoneal adenocarcinomatosis that builds on earlier studies. However, there are technical and cytokinetic limitations to their approach. From the technical standpoint, their perfusion system would not avoid streaming of flow. Like the authors, my approach would be to resect the primary cancer, omentum, and as much of the peritoneal implants as possible. Afterward, I would copiously irrigate the peritoneal cavity with 5% dextrose in water heated on last wash to 55°C and leave it in for only 3 to 5 minutes before removing. This temperature for short exposure is as thermolethal as the lower temperature used by the authors for longer periods. There is some evidence that the mucopolysaccharides forming the viscous ascites in pseudomyxoma are miscible in 5% dextrose in water. Also, 5% dextrose in water has an osmolytic effect on cells. The . . . [Full Text of this Article]

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