Operating personnel safety during the administration of Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Kyriazanos, Ioannis; Kalles, Vasileios; Stefanopoulos, Anastasios; Spiliotis, John; Mohamed, Faheez

doi:10.1016/j.suronc.2016.06.001

Cited by 49 publications

(76 citation statements)

References 30 publications

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“…Hence, it is very important that no contamination is observed in the environment from previous surgical activities before the PIPAC as this could negatively influence the results. Platinum was finally analyzed with voltammetry on a Computrace (Metrohm Ltd, Herisau, Switzerland) [16]. The results were corrected for potential background values of platinum (compounds) being present in the environment but who were not from platinum containing drugs.…”

Section: Sample Storage Preparation and Analysismentioning

confidence: 99%

Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC)

Willaert

Paul

Ceelen

2017

Pleura and Peritoneum

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Background: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a novel method to treat extensive, small volume peritoneal metastases. The clinical use of chemotherapy containing aerosols represents a potential occupational health hazard. We report the results of toxicological analysis during the first two clinical PIPAC procedures performed at Ghent University Hospital. Methods: After extensive preparation and in vitro testing, two patients were treated with PIPAC: the first using doxorubicin (2.86 mg in 51.43 mL) and cisplatin (14.28 mg in 164.3 mL), the second using oxaliplatin (182.10 mg in 186.42 mL). A standardized safety checklist was developed and used. Aerosol delivery was combined with electrostatic precipitation (ePIPAC). The following samples were obtained at several time points and locations: environmental air, floor surface wipes, surgeon's gloves, surgeon's hand wipes, circuit filters, and fluid from the water seal collection chamber container placed along the closed aerosol waste evacuating line. Platinum concentration was measured in these samples using voltammetry. Sample collection and analysis were performed by an independent external laboratory. Results: Platinum was not detected on the four floor locations after both procedures (detection limit 0.02 ng/ cm 2 ). Similarly, no platinum was detected in environmen-

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Section: Sample Storage Preparation and Analysismentioning

confidence: 99%

Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC)

Willaert

Paul

Ceelen

2017

Pleura and Peritoneum

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“…He or she also places absorbent floor mats with impervious backing around the OR bed and under suction canisters to absorb potential chemoperfusate spills. The OR team should prepare to use a filtered smoke evacuator to remove electrosurgery plume and vaporized cytotoxic chemicals if they will be using the open HIPEC method . Before the patient is brought into the room, the RN circulator also verifies the chemotherapy agent and dose with the surgeon.…”

Section: Preoperative Patient Care and Preparationmentioning

confidence: 99%

“…Cytoreductive surgery may take hours, depending on the amount of macroscopic tumor(s) to be removed. If gastrointestinal reconstruction or diversion is required, the surgeon usually performs these procedures after HIPEC to prevent encapsulating cancer cells in the suture line or staple . After tumor debulking, the surgeon irrigates the cavity to remove loose tissue and fat to prevent the hyperthermia perfusion pump's filtered reservoir from becoming clogged during use.…”

Section: Intraoperative Patient Carementioning

confidence: 99%

“…After the chemoperfusate lavage, the abdomen remains closed for the rinsing phase to flush the chemoperfusate from the abdomen . At HNMC, the surgeon uses IV bags of heated, chemotherapy‐free solution (eg, 0.9% NaCl) to flush the cavity.…”

Section: Intraoperative Patient Carementioning

confidence: 99%

“…The surgeon then reopens the incision and removes the catheters and temperature probes. If a bowel resection is needed, this is the ideal time to perform this procedure because the tumor burden is at its lowest level . The scrub person then prepares for the closing count.…”

Section: Intraoperative Patient Carementioning

confidence: 99%

See 2 more Smart Citations

Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy, Part II: Implementation

Dunn¹,

Ciccarelli²,

Moltzen³

2019

AORN Journal

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Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an extensive procedure used to treat peritoneal carcinomatosis, which is either primary or secondary to other cancers (eg, ovarian, colorectal, appendiceal) that have metastasized to the peritoneum. Morbidity, mortality, and quality of life have improved for patients selecting CRS with HIPEC as a cancer treatment. At Holy Name Medical Center in Teaneck, New Jersey, an interdisciplinary team was established to plan and coordinate performing this new procedure in the OR. The team created a written protocol for implementing CRS with HIPEC before patients were scheduled for surgery. This article explores the perioperative facets of implementing CRS with HIPEC and discusses care of the patient undergoing CRS with HIPEC, with a focus on perioperative nursing considerations.

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