Technology development of hyperthermic pressurized intraperitoneal aerosol chemotherapy (hPIPAC)

Autor: C. Bachmann, Alfred Königsrainer, Iaroslav Sautkin, Giorgi Nadiradze, Rami Archid, Marc A. Reymond, Frank-Jürgen Weinreich
Rok vydání: 2021
Předmět:
Zdroj: Surgical Endoscopy
ISSN: 1432-2218
0930-2794
DOI: 10.1007/s00464-021-08567-y
Popis: Background Optimized drug delivery systems are needed for intraperitoneal chemotherapy. The aim of this study was to develop a technology for applying pressurized intraperitoneal aerosol chemotherapy (PIPAC) under hyperthermic conditions (hPIPAC). Methods This is an ex-vivo study in an inverted bovine urinary bladder (IBUB). Hyperthermia was established using a modified industry-standard device (Humigard). Two entry and one exit ports were placed. Warm-humid CO2 was insufflated in the IBUB placed in a normothermic bath to simulate body thermal inertia. The temperature of the aerosol, tissue, and water bath was measured in real-time. Results Therapeutic hyperthermia (target tissue temperature 41–43 °C) could be established and maintained over 30 min. In the first phase (insufflation phase), tissue hyperthermia was created by insufflating continuously warm-humid CO2. In the second phase (aerosolization phase), chemotherapeutic drugs were heated up and aerosolized into the IBUB. In a third phase (application phase), hyperthermia was maintained within the therapeutic range using an endoscopic infrared heating device. In a fourth phase, the toxic aerosol was discarded using a closed aerosol waste system (CAWS). Discussion We introduce a simple and effective technology for hPIPAC. hPIPAC is feasible in an ex-vivo model by using a combination of industry-standard medical devices after modification. Potential pharmacological and biological advantages of hPIPAC over PIPAC should now be evaluated.
Databáze: OpenAIRE
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