Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey.
BACKGROUND
Over the last two decades, many surgical teams have developed programs to treat peritoneal carcinomatosis with extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Currently, there are no specific recommendations for HIPEC procedures concerning environmental contamination risk management, personal protective equipment (PPE), or occupational health supervision.


METHODS
A survey of the institutional practices among all French teams currently performing HIPEC procedures was carried out via the French network for the treatment of rare peritoneal malignancies (RENAPE).


RESULTS
Thirty three surgical teams responded, 14 (42.4%) which reported more than 10 years of HIPEC experience. Some practices were widespread, such as using HIPEC machine approved by the European Community (100%), individualized or centralized smoke evacuation (81.8%), "open" abdominal coverage during perfusion (75.8%), and maintaining the same surgeon throughout the procedure (69.7%). Others were more heterogeneous, including laminar flow air circulation (54.5%) and the provision of safety protocols in the event of perfusate spills (51.5%). The use of specialized personal protective equipment is ubiquitous (93.9%) but widely variable between programs.


CONCLUSIONS
Protocols regarding cytoreductive surgery/HIPEC and the associated professional risks in France lack standardization and should be established.
Department of Surgical Oncology, Claudius Regaud Institute - IUCT, Toulouse, France. Electronic address: ferron.gwenael@iuct-oncopole.fr.
G
G
Ferron
Department of Surgical Oncology, Claudius Regaud Institute - IUCT, Toulouse, France.
L
L
Simon
Department of Surgical Oncology, Bergonie Institute, Bordeaux, France.
F
F
Guyon
Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France; EMR 3738, Lyon 1 University, Lyon, France.
O
O
Glehen
Department of Surgical Oncology, Gustave Roussy Institute, Villejuif, France.
D
D
Goere
Department of Surgical Oncology, Gustave Roussy Institute, Villejuif, France.
D
D
Elias
Surgical Oncologic & Digestive Unit, Lariboisière University Hospital, Paris, France; INSERM, U 965, Paris, France.
M
M
Pocard
Department of Medical Oncology, Claudius Regaud Institute - IUCT, Toulouse, France.
L
L
Gladieff
Department of General Surgery, Archet 2 University Hospital, Nice, France.
J M
JM
Bereder
Department of General Surgery, Hautepierre University Hospital, Strasbourg, France.
C
C
Brigand
Department of Surgical Oncology, René Gauducheau Cancer Center, Nantes, France.
J M
JM
Classe
Department of Surgical Oncology, Francois Baclesse Comprehensive Cancer Center, Caen, France.
J M
JM
Guilloit
Department of Surgical Oncology, Val d'Aurelle Montpellier Cancer Center, Montpellier, France.
F
F
Quenet
Department of Digestive Surgery, University Hospital of Saint Etienne, Saint Etienne, France.
K
K
Abboud
Department of Digestive Surgery, Michallon University Hospital, Grenoble, France.
C
C
Arvieux
Department of Pathology, Val d'Aurelle Montpellier Cancer Center, Montpellier, France.
F
F
Bibeau
Department of Surgical Oncology, Paoli-Calmettes Institute, Marseille, France.
C
C
De Chaisemartin
Department of Digestive Surgery, Jean Minjoz University Hospital, Besançon, France.
D
D
Delroeux
Department of Visceral Surgery and Transplantation, Dupuytren University Hospital, Limoges, France.
S
S
Durand-Fontanier
Department of General Surgery, Diaconesses Croix Saint Simon Group Hospital, Paris, France.
N
N
Goasguen
Department of Digestive Surgery, Purpan University Hospital, Toulouse, France.
L
L
Gouthi
Department of Digestive Surgery, Jean Minjoz University Hospital, Besançon, France.
B
B
Heyd
Department of Digestive Surgery, Robert Debré University Hospital, Reims, France.
R
R
Kianmanesh
Department of Gynaecological Surgery, Oscar Lambret Cancer Center, Lille, France.
E
E
Leblanc
Department of Digestive Surgery, Tenon University Hospital, Paris, France.
V
V
Loi
Department of Surgical Oncology, Paul Papin Cancer Center, Angers, France.
G
G
Lorimier
Department of Surgical Oncology, Lorraine Institute of Oncology, Vandoeuvre-les-Nancy, France.
F
F
Marchal
Department of Surgical Oncology, Curie Institute, Paris, France.
P
P
Mariani
Department of Digestive and Oncological Surgery, Claude-Huriez University Hospital, Lille, France.
C
C
Mariette
Department of Surgery, Léon Bérard Comprehensive Cancer Center, Lyon, France.
P
P
Meeus
Department of Surgery, Louis Mourier University Hospital, Colombes, France.
S
S
Msika
Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France.
P
P
Ortega-Deballon
Department of Surgical Oncology, René Gauducheau Cancer Center, Nantes, France.
J
J
Paineau
Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France.
D
D
Pezet
Department of Digestive and Oncological Surgery, Claude-Huriez University Hospital, Lille, France.
G
G
Piessen
Department of Digestive Surgery, Timône University Hospital, Marseille, France.
N
N
Pirro
Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Center, Clermont-Ferrand, France.
C
C
Pomel
Department of Digestive Surgery, University Hospital of Saint Etienne, Saint Etienne, France.
J
J
Porcheron
Department of General Surgery, Antoine-Béclère University Hospital, Clamart, France.
G
G
Pourcher
Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France.
P
P
Rat
Department of Digestive Surgery, University Hospital of Amiens, Amiens, France.
J M
JM
Regimbeau
Department of Digestive Surgery, University Hospital of Amiens, Amiens, France.
C
C
Sabbagh
Department of Surgical Oncology, René Gauducheau Cancer Center, Nantes, France.
E
E
Thibaudeau
Department of Gynecology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
J J
JJ
Torrent
Department of Hepato-Gastroenterology, University Hospital, Poitiers, France.
D
D
Tougeron
Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France.
J J
JJ
Tuech
Department of Digestive and General Surgery, G. Pompidou European Hospital, Paris, France.
F
F
Zinzindohoue
Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France; EMR 3738, Lyon 1 University, Lyon, France.
P
P
Lundberg
Department of Occupational Medicine, University Hospital, Toulouse, France.
F
F
Herin
Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France.
L
L
Villeneuve
D000389:Air Conditioning / Q000379:methods*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000628:therapy*; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D005602:France; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007263:Infusions, Parenteral / Q000379:methods*; D016272:Occupational Health; D010534:Peritoneal Neoplasms / Q000628:therapy*; D000067393:Personal Protective Equipment / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D012308:Risk Management; D012906:Smoke; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents; D012906:Smoke
HIPEC; Intraperitoneal chemotherapy; Peritoneal carcinomatosis; Personal protective equipment; Practices survey; Professional risks