Isolated lung chemotherapeutic infusions for treatment of pulmonary metastases: a pilot study.
A pilot study was designed to determine the feasibility of combining minimally invasive surgery techniques and cardiac surgical catheter technology to deliver high-dose unilateral pulmonary chemotherapy. Single lung ventilation general anesthesia was combined with catheter-based left pulmonary artery (PA) control in 4 mongrel dogs. p-Aminohippuric acid (PAH) was used to quantify leakage of pulmonary arterial infusate. Surgical exposure was progressively less invasive. Dissection of cranial and caudal pulmonary veins followed methods used in minimally invasive pulmonary lobectomy. All animals survived the experimental procedure. The Heart-Port Endoplege catheter controlled the canine PA. A volume (50 cm(3)) of infusate much smaller than the calculated pulmonary vascular volume caused less vascular overdistention and diffused throughout the pulmonary vascular bed within 3-5 min as verified by fluoroscopy. 75% of the tracer remained in the lung at the completion of the 30-min dwell time. The pulmonary circulation can be isolated by minimally invasive operative and catheter technology so that the pulmonary parenchyma can be exposed to a high concentration of a compound for at least 30 min in the canine model.
Demmy
Todd L
TL
Department of Surgery, University of Missouri-Columbia School of Medicine, Columbia, MO, USA. Demmyt@missouri.edu
Wagner-Mann
Colette
C
Allen
Alisha
A
D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002404:Catheterization; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D004285:Dogs; D006801:Humans; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D009362:Neoplasm Metastasis; D010865:Pilot Projects; D011651:Pulmonary Artery / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D010130:p-Aminohippuric Acid / Q000652:urine
D000970:Antineoplastic Agents; D010130:p-Aminohippuric Acid