{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:21:32Z","timestamp":1788538892766,"version":"build-2803163510"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Selected high-risk appendiceal neoplasms with tumour perforation or T4 disease may be considered for risk-reducing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), even without overt radiological peritoneal disease. Since 2012, our centre has offered laparoscopic CRS-HIPEC, and a robotic approach was recently introduced to enhance visualisation, dexterity, and precision while minimising surgical trauma. This study evaluates the feasibility, safety, and early outcomes of risk-reducing robotic CRS-HIPEC (RCRS-HIPEC) in selected patients with high-risk appendiceal neoplasms without radiological peritoneal disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective single-centre case series was conducted at a national referral centre for peritoneal surface malignancy. Eight patients underwent standardised RCRS-HIPEC. The cohort included low-grade appendiceal mucinous neoplasm (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3), goblet cell carcinoma (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4), and appendiceal adenocarcinoma (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1). The standardised operative approach included omentectomy, falciform excision, umbilicectomy, and cholecystectomy or salpingo-oophorectomy where indicated, followed by closed HIPEC. Outcomes assessed included operative time, blood loss, complications, length of stay, histopathology, patient-reported recovery, and preliminary resource utilisation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Mean age was 65.8 years; there were 5 male and 3 female patients. Mean operative time was 6 h 19 min (\u00b125 min), with minimal blood loss (&lt;150 mL). No patient required epidural analgesia, parenteral nutrition, or prolonged critical care. Median time to first flatus was 3 days, and median hospital stay was 5 days. Two patients experienced Clavien\u2013Dindo grade I morbidity, with no major complications. Histopathology demonstrated residual disease in two patients. Early electronic patient-reported outcome measures suggested favourable recovery, and preliminary Patient Level Information and Costing System data indicated potential NHS resource savings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>RCRS-HIPEC is feasible and safe in carefully selected patients with high-risk appendiceal neoplasms without radiological peritoneal disease. A standardised robotic approach may promote reproducibility, support enhanced recovery, and reduce healthcare resource use. Larger comparative studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_528_25","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:00:12Z","timestamp":1788537612000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Robotic cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy for selected appendiceal neoplasms: Early experience from a national referral centre"],"prefix":"10.4103","author":[{"given":"Prateek","family":"Arora","sequence":"first","affiliation":[{"name":"Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malinga","family":"Gallala","sequence":"additional","affiliation":[{"name":"Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, 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