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IMAGES FOR SURGEONS
Pseudomyxoma peritonei (PMP) is a progressive disease of the perito- neum that results in mucinous secreting cells implanting in various regions of the peritoneal cavity. Intra-abdominal cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC) and early
post-operative chemotherapy are the current gold standard for treat- ment.1 In rare situations, it can disseminate into the pleura, which is thought to be related to diaphragmatic perforation during abdominal surgery or trans-diaphragmatic spread of disease through lymphatic
(a) Computed tomography imaging showing pleural lesions (white arrows) and (b and c) intraoperative set up demonstrating the in ow (red) and out- ow (blue) lines, going through the 28-Fr drains into the thoracic cavity. The thoracotomy is retracted using an Alexis retractor, which is covered with Ioban . An incision is made to allow for a gaseous suction, which is covered with Ioban to maintain a seal. A small hole is created in the thoracotomy to ensure the gaseous suction remains open to air and therefore does not suck out any chemotherapeutic agents being irrigated in the pleural cavity.3
© 2021 Royal Australasian College of Surgeons ANZ J Surg (2021)
Reprinted with permission from the journal – ANZ J Surg
13 NOVEMBER 2022 | www.anzcp.org
