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Safety monitoring of the coliseum technique for heated intraoperative intraperitoneal chemotherapy with mitomycin C

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Abstract

Background

Treatment of carcinomatosis may involve the use of heated intraperitoneal chemotherapy; the cytotoxic solution is administered in the operating room with the abdomen open so that manual distribution results in uniform treatment. The potential risk of this procedure to the operating room personnel has not been previously investigated.

Methods

Mitomycin C was perfused through the peritoneal cavity, which was partially covered by a plastic sheet. Large volumes of air were suctioned from 5 and 35 cm above the abdominal skin edge. Urine from the surgeon and from the perfusionist were assayed. Sterile gloves worn in the operating room for manipulating the viscera during treatment were assayed for their permeability to mitomycin C. All samples were analyzed by high-performance liquid chromatography.

Results

Analysis of samples of operating room air and urine from 10 procedures showed no detectable levels of mitomycin C. Six tests of three different types of gloves showed a 10-fold range of mitomycin C penetration. The least permeable gloves leaked a mean of 3.8 parts per million over 90 minutes.

Conclusions

No detectable safety hazard to the surgeon or other operating room personnel was demonstrated.

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References

  1. Sugarbaker PH, Cunliffe W, Belliveau JF, et al. Rationale for perioperative intraperitoneal chemotherapy as a surgical adjuvant for gastrointestinal malignancy.Reg Cancer Treat 1988;1:66–79.

    Google Scholar 

  2. Sugarbaker PH, Averbach AM, Jacquet P, Stephens AD, Stuart OA. A simplified approach to hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) using a self retaining retractor. In: Sugarbaker PH, ed.Peritoneal Carcinomatosis: Principles of Management. Boston: Kluwer, 1996:415–21.

    Google Scholar 

  3. Urano M, Kuroda M, Nishimura Y. The clinical application of thermochemotherapy given at mild temperatures (invited review).Int J Hyperthermia 1999;15:79–107.

    Article  PubMed  CAS  Google Scholar 

  4. Jacquet P, Averbach AM, Stuart OA, Chang D, Sugarbaker PH. Hyperthermic intraperitoneal doxorubicin: pharmacokinetics, metabolism and tissue distribution in a rat model.Cancer Chemother Pharmacol 1998;41:147–54.

    Article  PubMed  CAS  Google Scholar 

  5. Stephens AD, Alderman R, Chang D, et al. Morbidity and mortality of 200 treatments with cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy using the coliseum technique.Ann Surg Oncol 1999;6:790–6.

    Article  PubMed  CAS  Google Scholar 

  6. Jacquet P, Averbach A, Stephens AD, Stuart OA, Chang D, Sugarbaker PH. Heated intraoperative intraperitoneal mitomycin C and early postoperative intraperitoneal 5-fluorouracil: pharmacokinetic studies.Oncology 1998;55:130–8.

    Article  PubMed  CAS  Google Scholar 

  7. Tjaden UR, DeBruijn EA, Van Der Hoeven RAM, Jol C, Van Der Greef J, Lingeman H. Automated analysis of mitomycin C in body fluids by high performance liquid chromatography with on-line sample pre-treatment.J Chromatogr B Biomed Appl 1987;420:53–62.

    Article  CAS  Google Scholar 

  8. Eksborgh S, Ehrsson H, Lindfors A. Liquid chromatographic determination of mitomycin C in human plasma and urine.J Chromatogr B Biomed Appl 1983;274:263–70.

    Article  Google Scholar 

  9. Den Hartigh J, McVie JG, van Oort WJ, Pinedo HM. Pharmacokinetics of mitomycin C in humans.Cancer Res 1983;43:5-17–5-21.

    Google Scholar 

  10. Hallenbeck P, Sanniez CK, Ryan AB, Neily B, Sugarbaker PH. Cytoreductive surgery and intraperitoneal chemotherapy.AORN J 1992;56:50–72.

    PubMed  CAS  Google Scholar 

  11. Jacquet P, Stephens AD, Averbach AM, et al. Analysis of morbidity and mortality in 60 patients with peritoneal carcinomatosis treated by cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy.Cancer 1996;77:2622–9.

    Article  PubMed  CAS  Google Scholar 

  12. Sugarbaker PH, Jacquet P, Stephens AD, Stuart OA, Averbach AM. Comparison of covered versus closed technique for heated intraoperative intraperitoneal chemotherapy for peritoneal carcinomatosis from gastrointestinal cancer. In: Abe O, Inokuchi K, Takasaki K, eds.XXX World Congress of the International College of Surgeons. Bologna: Monduzzi Editore, 1996:389–93.

    Google Scholar 

  13. Stephens AD, White SK, Sugarbaker PH. Guidelines for the safe administration of perioperative intraperitoneal chemotherapy. In: Bleiberg H, Rougier P, Wilke WI, eds.Management of Colorectal Cancer. London: Martin Dunitz, 1998:145–52.

    Google Scholar 

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Correspondence to Paul H. Sugarbaker MD.

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Stuart, O.A., Stephens, A.D., Welch, L. et al. Safety monitoring of the coliseum technique for heated intraoperative intraperitoneal chemotherapy with mitomycin C. Annals of Surgical Oncology 9, 186–191 (2002). https://doi.org/10.1007/BF02557372

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  • DOI: https://doi.org/10.1007/BF02557372

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