Side Effects of HIPEC: What to Expect and How to Manage Them

What Is HIPEC?

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is administered directly into the abdominal cavity at elevated temperatures (41–43°C) after cytoreductive surgery. This combination targets microscopic tumour deposits on the peritoneum with concentrations 20–30 times higher than systemic chemotherapy, while limiting systemic exposure.

Expected Side Effects

HIPEC is a major surgical procedure and its recovery involves significant physiological changes:

Haematological toxicity: Bone marrow suppression causing low blood counts (neutropenia, anaemia, thrombocytopenia) peaks at 10–14 days post-surgery. Regular blood tests and sometimes growth factor support are needed.

Renal toxicity: Particularly with cisplatin-based HIPEC. Adequate hydration, diuretics and close monitoring of creatinine are standard protective measures.

Gastrointestinal effects: Nausea, vomiting and ileus are common in the first days. Nasogastric drainage and graduated oral intake manage these.

Fatigue: Significant fatigue is expected for weeks to months after surgery. Gradually improves with rehabilitation.

Wound-related complications: As with any major abdominal surgery: infection, hernia, delayed healing.

Hospital Stay and Recovery

Typical hospitalisation is 7–14 days. ICU monitoring for 24–48 hours post-operatively is standard. Full recovery takes 6–12 weeks. Patients should avoid strenuous activity, follow a progressive diet and attend all scheduled follow-up appointments.

Managing Side Effects

Anti-nausea medications, adequate hydration, pain management with multimodal analgesia, early physiotherapy and nutritional support are all integral parts of HIPEC post-operative care at experienced centres.