Author/Editor		Fras, AP; Šušteršič, M
Title		A novel technical approach to intraperitoneal chemotherapy (IPC)
Type		članek
Source		In: Mozzillo N, Parisi V, editors. Selected free papers of the 2nd cancer symposium, 25 congresso nazionale di Societa Italiana di chirurgia oncologica - SICO, 2nd world congress of the World federation of surgical oncology societies - WFOS; 2001 Sep 19-22; Naples. Bologna: Monduzzi editore, International proceedings division,
Publication year		2001
Volume		str. 89-93
Language		eng
Abstract		Objectives: The pharmacological basis for IPC is the difference between the plasma and peritoneal clearance rates of antineoplastic agents. Cisplatinum (CPD) is well suited for IPC. The goals of IPC are high drug delivery to tumor and decreased systemic toxicity. Peritoneal implants, especially in low-grade and mucinous tumors, are a therapeutic challenge. Mucinous fluid is difficult to be evacuated by abdominal drainage; therefore, instead of a standard closure, we used a zip closure of laparotomy that enables efficient and repeated removals of mucinous fluid and applications of IPC. Methods: A 62-year-old patient with ovarian tumor and wide- spread intra-abdominal implants and mucinous fluid (stage III, FIGO) underwent laparotomy after laparoscopy. Debulking surgery with removal of a large ovarian cyst and omentectomy was performed. Histology showed a borderline ovarian tumor. Instead of standard wound closure, we used a zip (Ethizip Ethicon) that allowed repeated IPC and removals of mucinous fluid. Altogether 20-50 mg of CDP dissolved in 400 ml of Soludex (PLIVA) was applied intraabdominally in 48 - 96-hour intervals under general anesthesia. A total dose of 260 mg of CDP was given in 7 applications. Results: In subsequent applications of CDP, the abdominal cavity could be examined. A regression of tumor implants was noticed; they were easily removed from serosa. Three weeks after the 7th CDP application, a total abdominal hysterectomy and removal of fibrinous deposits was performed. There were no post-operative complications. Histology showed no residual epithelial cells. The patient is well and disease-free 8 years after the treatment. (Abstract truncated at 2000 characters).
Descriptors		OVARIAN NEOPLASMS LAPAROTOMY CISPLATIN PERITONEAL CAVITY MIDDLE AGE DRUG IMPLANTS