Peritonectomy of the colonic mesentery. Case report of a new surgical technology.

Malignant peritoneal mesothelioma is a local-regional disease process that requires a comprehensive treatment plan including complete cytoreductive surgery and regional chemotherapy. Treatments used in our patient began with a complete cytoreductive surgery. This required visceral resections, parietal peritonectomy, peritonectomy of the small bowel and its mesentery, and a peritoneal resection of the colonic mesentery with sparing of the major vasculature of the large bowel. Peritoneal resection of the colonic mesentery and other treatments were performed in the absence of major complications. A 20-day hospitalization was required. The patient shows no internal hernias and no evidence of disease by CT follow-up at 4 years postoperatively. Her quality of life is excellent. Malignant peritoneal mesothelioma was in the past a disease of limited survival without effective treatment options. Peritoneal resection of the colonic mesentery may be required for complete cytoreduction. A sequence of cytoreductive surgical procedures and regional chemotherapy treatments has made long-term survival possible. • Malignant peritoneal mesothelioma has treatment options that combined surgery and regional chemotherapy. • A major surgical challenge is complete mesenteric peritonectomy. • Complete cytoreduction of the large bowel mesentery requires its resection with sparing major vasculature. • Long-term survival is possible with low perioperative morbidity and mortality. [ABSTRACT FROM AUTHOR]