İstanbul Üniversitesi İstanbul Tıp Fakültesi Genel Cerrahi Anabilim Dalı
Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) for peritoneal surface malignancies. HIPEC-certified surgeon in Istanbul.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a locoregional treatment strategy for cancers that have spread to the peritoneum — the thin membrane lining the inner abdominal wall and covering abdominal organs. It combines cytoreductive surgery (CRS), which removes all visible peritoneal tumor deposits, with the intraoperative administration of heated chemotherapy solution directly into the abdominal cavity.
The rationale for hyperthermia is dual: temperatures of 41–43°C are directly cytotoxic to tumor cells and enhance drug penetration into tumor tissue. Intraperitoneal delivery achieves drug concentrations 20–1,000 times higher than systemic administration, while markedly limiting systemic toxicity.
📌 Important: CRS+HIPEC is a major surgical undertaking. Appropriate patient selection — by an experienced multidisciplinary tumor board team — is the most critical determinant of outcome. Not all patients with peritoneal metastases are suitable candidates.
Rigorous patient selection is the cornerstone of CRS+HIPEC outcomes. The key eligibility criteria include:
Every patient considered for CRS+HIPEC must be evaluated by a multidisciplinary tumor board including surgery, medical treatment planning, radiology, and pathology. No patient proceeds to surgery without board consensus.
Phase 1 — Cytoreductive Surgery: All visible peritoneal tumor deposits are systematically excised. This may include peritonectomy procedures (parietal and visceral peritoneum stripping), omentectomy, and resection of involved organs (bowel, spleen, gallbladder, uterus/ovaries). Complete cytoreduction (CC-0) is the primary surgical objective.
Phase 2 — HIPEC: Immediately following cytoreduction, a heated chemotherapy solution (typically oxaliplatin or mitomycin C for colorectal cancer; cisplatin for mesothelioma) is circulated through the abdominal cavity at 41–43°C for 60–90 minutes using a closed or open (coliseum) technique. The abdomen is then irrigated and closed.
Prof. Dr. Hakan Yanar holds certification in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) and is one of the few surgeons in Istanbul performing this procedure at Liv Hospital Ulus. International candidates for HIPEC are evaluated through a structured multidisciplinary process, with consultations available in English, French, and Russian.
Contact Prof. Dr. Hakan Yanar to evaluate your candidacy for CRS+HIPEC in Istanbul.
