Background/aim: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is becoming an increasingly widespread approach for delivering intra-peritoneal chemotherapy (IPC) by means of a chemoaerosol. Currently, the aerosol dispersion is achieved by using a special micropump (MIP®). However, the delivery of a chemoaerosol into the abdominal cavity is not limited to the MIP®. This study aimed to investigate the feasibility, drug penetration and distribution of PIPAC via an established endoscopical microcatheter (MC).
Materials and methods: An established ex vivo PIPAC model containing native fresh tissue samples of swine peritoneum was used to aerosolize doxorubicin at a pressure of 12 mm Hg CO2 at 27° degrees Celsius. On the top cover of the PIPAC chamber a MC device was installed via trocar. Tissue specimens were placed as follows: at the bottom of the plastic box (A), at the side wall (B), at the top (C) and the covered bottom (D) of the box. In-tissue doxorubicin penetration was measured using fluorescence microscopy on frozen thin sections.
Results: The mean depth of doxorubicin penetration was found to be significantly higher in tissue directly exposed to the aerosol jet. All samples had contact with doxorubicin. Penetration rates were: A: 348 (+/- 47 μm), B: 174 (+/- 64 μm), C: 92 (+/- 27 μm) and D: 84 (+/- 45) μm.
Conclusion: Our ex vivo data suggest that PIPAC can be delivered via MC device. While local drug penetration is practically congruent to known PIPAC performance with MIP®, the MC offers a feasible, flexible, easy to handle and economic improvement compared to conventional PIPAC.
Keywords: PIPAC; Pressurized intra-peritoneal aerosol chemotherapy; doxorubicin; ex vivo; swine.
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