Peritoneum

The peritoneum is an approximately two square meter large, very thin covering of the inner abdominal wall. as well as the internal organs. It is divided into the parietal (covering the abdominal wall) and visceral peritoneum (covering the abdominal organs). Its function is to allow the internal organs to glide over each other, enabling movements like bowel motion or breathing (diaphragm). Additionally, the peritoneum plays a critical role in other important processes, such as the regulation of inflammatory processes. Malignant diseases of the peritoneum

Peritoneal carcinomatosis

There is a distinction between primary tumors of the peritoneum and metastases in or on the peritoneum. When a tumor of an abdominal organ, e.g., the colon, spreads to the peritoneum, it is referred to as peritoneal carcinomatosis. This typically appears as coarse or fine nodules on the inner abdominal wall or throughout the entire abdominal cavity.

Therapy

If an operative therapy is deemed sensible and technically feasible, the surgical removal of the affected peritoneum and a chemotherapy lavage of the abdominal cavity with warmed chemotherapeutic agent (so-called hyperthermic intraperitoneal chemotherapy – HIPEC) is performed. By warming the solution to 43 °C, the toxic effect on the tumor cells is enhanced and the penetration depth into the tissue is increased. Until a few years ago, the diagnosis of peritoneal carcinomatosis was considered the terminal stage of the disease. Today, through surgery and HIPEC, a significantly longer survival time - in some cases even cure - can be achieved.