title: Operating personnel safety during the administration of Hyperthermic Intraperitoneal Chemotherapy (HIPEC).
abstract: Cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is increasingly used in the treatment of peritoneal malignancies. The administration of HIPEC after complete cytoreduction offers the combination of the pharmacokinetic advantages inherent to the intraperitoneal delivery of cytotoxic chemotherapy, with the direct cytotoxic effects of hyperthermia, and has been reported to offer significantly improved patient outcomes. As a result, this novel method disseminates rapidly, with many surgical teams having developed peritoneal malignancy treatment programs. Protocols are needed for the introduction, handling, and management of chemotherapeutic agents in the operating room to minimize risk to the staff involved in the procedure. The personnel exposure during CRS and HIPEC may arise from different routes, such as air contamination, direct contact, manipulation of perfusates or chemotherapy solutions, and manipulation of objects/tissues exposed to chemotherapeutics. Guidelines for safe administration of HIPEC including environmental contamination risk management, personal protective equipment, and occupational health issues are yet to be established. This review summarizes the existing evidence regarding the safety considerations of HIPEC administration.
authors: 2nd Department of Surgery, Naval and Veterans Hospital of Athens, Greece.
authors: Ioannis
authors: I
authors: Kyriazanos
authors: 2nd Department of Surgery, Naval and Veterans Hospital of Athens, Greece. Electronic address: vassilis_kalles@yahoo.gr.
authors: Vasileios
authors: V
authors: Kalles
authors: 2nd Department of Surgery, Naval and Veterans Hospital of Athens, Greece.
authors: Anastasios
authors: A
authors: Stefanopoulos
authors: 1st Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece.
authors: John
authors: J
authors: Spiliotis
authors: Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, United Kingdom.
authors: Faheez
authors: F
authors: Mohamed
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D016272:Occupational Health; D010534:Peritoneal Neoplasms / Q000628:therapy*; D000067393:Personal Protective Equipment / Q000706:statistics & numerical data*; D011379:Prognosis; D012308:Risk Management
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy; Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Operator safety; Peritoneal surface malignancy