Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) through a single port: alternative delivery for the control of peritoneal metastases.

ABSTRACT Peritoneal carcinomatosis is the natural course of gastrointestinal, gynecologic, and primary peritoneal neoplasms. In recent years, our understanding of carcinomatosis has changed; it is no longer considered a disseminated condition, but rather a disease confined to the peritoneum. Thus, the combination of cytoreductive surgery and intraperitoneal chemotherapy has become the cornerstone of control of peritoneal metastases. Traditionally, intraperitoneal chemotherapy is delivered in the form of liquid solutions. However, a new mode of chemotherapy delivery to the abdominal cavity has arisen as an alternative to the conventional method. In Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC), the liquid solution is aerosolized into a spray, potentiating the distribution and penetration of the chemotherapeutic agent intraperitoneally. The present study aims to describe a novel form of this innovative surgical technique performed for the first time in Brazil, in a modification of the technique originally described for PIPAC: delivery through a single-port device.

摘要：腹膜癌病（Peritoneal carcinomatosis）是胃肠道肿瘤、妇科肿瘤及原发性腹膜肿瘤的自然病程。近年来，学界对该癌病的认知已发生转变：其不再被视为播散性疾病，而是一种局限于腹膜的病症。因此，细胞减灭术（cytoreductive surgery）联合腹腔化疗（intraperitoneal chemotherapy）已成为控制腹膜转移瘤（peritoneal metastases）的核心治疗手段。传统腹腔化疗以液态溶液形式给药，但目前已涌现出一种新型腹腔化疗给药方式，可作为传统方法的替代方案。在加压腹腔气溶胶化疗（Pressurized Intraperitoneal Aerosol Chemotherapy，PIPAC）中，液态化疗溶液被雾化为喷雾状，可增强化疗药物在腹腔内的分布与渗透能力。本研究旨在介绍一种经改良的PIPAC创新手术技术的新术式：该术式首次在巴西开展，采用单孔器械（single-port device）完成给药，其原型为最初报道的PIPAC标准技术。