{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T07:59:42Z","timestamp":1762070382802,"version":"build-2065373602"},"reference-count":54,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III"},{"name":"European Development Regional Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) has evolved as a treatment for peritoneal carcinomatosis in various tumors after a careful and complete cytoreductive surgery, and it demonstrated much better and longer survival than more traditional therapeutic schemas. Our objective has been to examine the safety, efficacy and survival achieved with closed technique with CO2-agitation system Combat PRS\u00ae (Peritoneal Recirculation System: PRS). To achieve this, we compared the appearance of adverse events, mortality and survival with the described using classic techniques (open, closed without CO2-agitation) for the treatment of selected patients with peritoneal carcinomatosis; Materials and methods: We studied overall survival, disease-free survival and safety (morbidity and mortality) of the administration of HIPEC through a closed method technique with CO2 recirculation (Combat PRS\u00ae) in 482 patients from 11 Spanish hospitals; Results: The mortality of our technique (1.66%) was similar to other published techniques (open, closed). Morbidity exhibited a 9.96% rate of Clavien-Dindo (CD) III\/IV complications in 482 patients, which was lower than in other series. Survival (overall survival (OS) and disease-free survival (DFS)) was similar to previously published results: 86% 1y-OS, 54% 3y-OS, 77% 1y-DFS and 31% 3y-DFS; Conclusion: The procedure with closed PRS with CO2 agitation is as safe as standard open and closed procedures for the administration of HIPEC after complete cytoreductive surgery, with similar and very low mortality (1.66%) and lower morbidity (9.96% CD III and IV in our series vs range of 20\u201340% in the majority of different series); only Kusamura had similar results, with 12% in 205 patients, using the closed technique without CO2 agitation).<\/jats:p>","DOI":"10.3390\/jcm11206152","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T02:54:25Z","timestamp":1666148065000},"page":"6152","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hyperthermic Intraperitoneal Chemotherapy and Recirculation with CO2: A Safe Technique"],"prefix":"10.3390","volume":"11","author":[{"given":"Remedios","family":"G\u00f3mez-Sanz","sequence":"first","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"},{"name":"Spanish Group of Peritoneal Oncologic Surgery (GECOP), Principe de Asturias Teaching Hospital, University of Alcal\u00e1 de Henares, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4254-3594","authenticated-orcid":false,"given":"Enrique","family":"Ovejero-Merino","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"},{"name":"Spanish Group of Peritoneal Oncologic Surgery (GECOP), Principe de Asturias Teaching Hospital, University of Alcal\u00e1 de Henares, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inmaculada","family":"Lasa-Unz\u00fae","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7159-043X","authenticated-orcid":false,"given":"Adela","family":"L\u00f3pez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Marcos-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"M\u00ednguez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5360-0577","authenticated-orcid":false,"given":"Francisca","family":"Garc\u00eda-Moreno Nisa","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1046-6344","authenticated-orcid":false,"given":"Fernando","family":"Mendoza-Moreno","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"D\u00edez-Alonso","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2588-1708","authenticated-orcid":false,"given":"Miguel A","family":"Ortega","sequence":"additional","affiliation":[{"name":"Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcal\u00e1, 28801 Alcal\u00e1 de Henares, Spain"},{"name":"Ram\u00f3n y Cajal Institute of Sanitary Research (IRYCIS), Hospital Universitario Pr\u00edncipe de Asturias, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1309-7510","authenticated-orcid":false,"given":"Melchor","family":"\u00c1lvarez-Mon","sequence":"additional","affiliation":[{"name":"Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcal\u00e1, 28801 Alcal\u00e1 de Henares, Spain"},{"name":"Ram\u00f3n y Cajal Institute of Sanitary Research (IRYCIS), Hospital Universitario Pr\u00edncipe de Asturias, 28034 Madrid, Spain"},{"name":"Immune System Diseases-Rheumatology and Internal Medicine Service, University Hospital Pr\u00edncipe de Asturias, (CIBEREHD), 28806 Alcal\u00e1 de Henares, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Guti\u00e9rrez-Calvo","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Pr\u00edncipe de Asturias Teaching Hospital, 28805 Madrid, Spain"},{"name":"Spanish Group of Peritoneal Oncologic Surgery (GECOP), Principe de Asturias Teaching Hospital, University of Alcal\u00e1 de Henares, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the Spanish PRS Collaborating Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1016\/j.suronc.2010.09.002","article-title":"Treatment of peritoneal carcinomatosis with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: State of the art and future developments","volume":"20","author":"Roviello","year":"2011","journal-title":"Surg. 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