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The administration of pressurized intraperitoneal aerosol chemotherapy (PIPAC) offers new treatment options for patients with peritoneal carcinomatosis, that is, with metastases in the peritoneum, who are not candidates for curative surgical treatment. "Intravenous systemic chemotherapy is the standard treatment in patients with advanced cancer which cannot be completely removed due to the great volume of the disease," says Dr. Gloria Ortega, of the Surgical Oncology Service of MD Anderson Madrid. "The problem is that patients in treatment with systemic chemotherapy begin to have numerous complications derived from the treatment," specialist goes on, who points out that PIPAC is treatment that, while used in combination with systemic chemotherapy, "allows the disease to be controlled with fewer adverse effects".

 Total mesorectal excision, that is, the removal of the rectum and surrounding fat and lymph nodes, is the standard treatment for rectal cancer - an effective approach that can be performed by laparotomy (open surgery), laparoscopy or robot-assisted surgery. The problem with this approach is "the lack of clear vision of the most distal part of the rectum, which makes complete resection of the tumor difficult", explains Dr. Oscar Alonso, a specialist in gastrointestinal surgical oncology at MD Anderson Madrid. Therefore, the closer the tumor is to the anus, the more difficult it is to see and more likely the resection is to be incomplete and with tumor recurrence.