title: Feasibility of hyperthermic pressurized intraperitoneal aerosol chemotherapy in a porcine model.
abstract: Peritoneal carcinomatosis is an unmet therapeutic need. Several types of intraperitoneal chemotherapy have been introduced. However, hyperthermic intraperitoneal chemotherapy has limited drug distribution and poor peritoneal penetration. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) does not have the benefits of hyperthermia. We developed a device to apply hyperthermic PIPAC (H-PAC) and evaluated its feasibility in a porcine model.
  
  
  
  The device for H-PAC consisted of a laparoscopic aerosol spray and a heater to create hyperthermic capnoperitoneum. We operated on five pigs for the development of the new device and on another five pigs as a survival model. After a pilot experiment of the survival model (Pig A), a hyperthermic pressurized intraperitoneal aerosol of indocyanine green was administered after insertion of three trocars (Pig B) and laparoscopy-assisted distal gastrectomy (LADG) (Pig C) without chemotherapeutic agents. After that, H-PAC with cisplatin was administered after insertion of three trocars (Pig D) and LADG (Pig E). Autopsies were performed on postoperative day 7.
  
  
  
  Median operation time was 85 min (80-110 min). Intraperitoneal temperature was constant for 1 h of H-PAC (38.8-40.2 °C). All five pigs were healthy and survived for 7 days. Median weight loss was 0.2 kg. Autopsy tissues of stomach, peritoneum, and jejunum were intact in all five pigs.
  
  
  
  H-PAC was feasible and safe in a porcine model.
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea.|Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Do Hyun
authors.initials: do H
authors.lastname: Jung
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea.|Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Son
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea.|Department of General Surgery, Tan Tock Seng Hospital, Novena, Singapore.
authors.forename: Aung Myint
authors.initials: AM
authors.lastname: Oo
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea.
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea.
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Shin
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea.|Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea.|Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Do Joong
authors.initials: do J
authors.lastname: Park
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyenggi-do, Seoul, 463-707, Korea. hhkim@snubh.org.|Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. hhkim@snubh.org.
authors.forename: Hyung-Ho
authors.initials: HH
authors.lastname: Kim
mesh_terms: D000336:Aerosols; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage*; D005743:Gastrectomy; D006979:Hyperthermia, Induced; D010535:Laparoscopy; D023421:Models, Animal; D010534:Peritoneal Neoplasms / Q000628:therapy*; D013552:Swine
chemical_list: D000336:Aerosols; D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Aerosol; Hyperthermia; Laparoscopic surgery; Peritoneal carcinomatosis; Peritoneum therapy; Pneumoperitoneum