Safety of health workers during hyperthermic intraperitoneal chemotherapy procedure
Peritoneal carcinomatosis (PC) is often considered an end-stage condition. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as the only potentially curative treatment for PC. This multimodal procedure involves aggressive multivisceral resections and peri...
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Published in | Turkish journal of colorectal disease Vol. 27; no. 4; pp. 110 - 116 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Türk Kolon Ve Rektum Cerrahisi Derneği
26.01.2018
Galenos Publishing House |
Subjects | |
Online Access | Get full text |
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Summary: | Peritoneal carcinomatosis (PC) is often considered an end-stage condition. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal
chemotherapy (HIPEC) has emerged as the only potentially curative treatment for PC. This multimodal procedure involves aggressive multivisceral
resections and peritonectomy aimed at achieving a complete cytoreduction, with no macroscopic residual tumor volume within the abdomen.
After surgery, a heated chemotherapy perfusate is administered intraoperatively into the abdomen to cover all peritoneal surfaces. Thus, sufficient
intraabdominal chemotherapeutic drug concentration can be achieved without systemic side effects. Hyperthermia enhances the effect of intraperitoneal
chemotherapy by increasing peritoneal blood flow, by direct cytotoxic effect, and by altering the tumor microenvironment. During this procedure, the
health worker is at risk of exposure to cytotoxic agents at various stages (such as through air contamination or direct contact during manipulation
of perfusates or chemotherapy solutions and manipulation of objects/tissues exposed to chemotherapeutics). In addition, the use of high-voltage
electrocautery during the removal of both peritoneal surfaces and tumor deposits during CRS exposes the health worker to large amounts of surgical
smoke for extended periods of time. Inhalation of this smoke may pose a risk to the health-care worker. Guidelines for the safe implementation of CRS
and HIPEC have not yet been established. This study summarizes the current evidence on security considerations of CRS and HIPEC management. |
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ISSN: | 2536-4898 2536-4901 |
DOI: | 10.4274/tjcd.50251 |