title: Pseudomyxoma peritonei: does a true mucolytic agent exist? In vitro and in vivo studies.
abstract: Reproducibility of the so-called "mucolytic effect" of the 2%-10% dextrose-water solution is questioned. To test the mucolytic effect of 5% and 10% dextrose-water solutions and to determine what could be a true mucolytic agent, in vitro and in vivo studies were undertaken in two proven pseudomyxoma peritonei cases. In vitro study: Immediately after the mucin jelly was taken out of the peritoneal cavity, the jelly was immersed in various 40 cc solutions including: 1) 5% dextrose-water; 2) 10% dextrose-water; 3) normal saline; 4) lactated Ringer; 5) distilled water. The mucolytic effects of these solutions were observed once every hour after vigorous mixing. In vivo study: After completion of the operation, the peritoneal cavity was repeatedly irrigated with massive warm 5% dextrose-water and normal saline solutions in an attempt to dissolve the residual mucin cake and jelly. Neither 5% and 10% dextrose-water solution nor control solutions of normal saline, lactated Ringer, and distilled water could dissolve the mucin jelly in test tubes at 0, 1, 2, and 3 hours. The "claimed" mucolytic agent, 5% dextrose-water solution could not facilitate the removal of both mucin jelly and cake in the peritoneal cavity. The 5% dextrose-water solution was not superior to the normal saline solution in terms of mucolytic effect. In the present study, a true mucolytic agent does not exist. Currently, multiple laparotomy for aggressive cytoreduction remains the treatment of choice for pseudomyxoma peritonei.
authors.affiliation: Department of Surgery, Veterans General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Shyr
authors.forename: C H
authors.initials: CH
authors.lastname: Su
authors.forename: H C
authors.initials: HC
authors.lastname: Wang
authors.forename: S S
authors.initials: SS
authors.lastname: Lo
authors.forename: W Y
authors.initials: WY
authors.lastname: Lui
mesh_terms: D000368:Aged; D005100:Expectorants / Q000008:administration & dosage*; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D066298:In Vitro Techniques; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000628:therapy; D011553:Pseudomyxoma Peritonei / Q000473:pathology / Q000628:therapy*; D000077325:Ringer's Lactate; D012965:Sodium Chloride / Q000008:administration & dosage; D007507:Therapeutic Irrigation
chemical_list: D005100:Expectorants; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012965:Sodium Chloride; D005947:Glucose