丝裂霉素C热灌注术中腹腔内化疗的大剧场技术安全性监测
Safety monitoring of the coliseum technique for heated intraoperative intraperitoneal chemotherapy with mitomycin C.
作者信息
Stuart O Anthony, Stephens Arvil D, Welch Laura, Sugarbaker Paul H
机构信息
Washington Cancer Institute, Occupational and Environmental Medicine, Washington Hospital Center, Washington, DC 20010, USA.
出版信息
Ann Surg Oncol. 2002 Mar;9(2):186-91. doi: 10.1007/BF02557372.
BACKGROUND
Treatment of carcinomatosis may involve the use of heated intraperitoneal chemotherapy; the cytotoxic solution is administered in the operating room with the abdomen open so that manual distribution results in uniform treatment. The potential risk of this procedure to the operating room personnel has not been previously investigated.
METHODS
Mitomycin C was perfused through the peritoneal cavity, which was partially covered by a plastic sheet. Large volumes of air were suctioned from 5 and 35 cm above the abdominal skin edge. Urine from the surgeon and from the perfusionist were assayed. Sterile gloves worn in the operating room for manipulating the viscera during treatment were assayed for their permeability to mitomycin C. All samples were analyzed by high-performance liquid chromatography.
RESULTS
Analysis of samples of operating room air and urine from 10 procedures showed no detectable levels of mitomycin C. Six tests of three different types of gloves showed a 10-fold range of mitomycin C penetration. The least permeable gloves leaked a mean of 3.8 parts per million over 90 minutes.
CONCLUSIONS
No detectable safety hazard to the surgeon or other operating room personnel was demonstrated.
背景
癌性腹膜炎的治疗可能涉及使用腹腔内热化疗；细胞毒性溶液在手术室中于腹部开放的情况下给药，以便通过手动分布实现均匀治疗。此前尚未对该操作对手术室人员的潜在风险进行研究。
方法
将丝裂霉素C灌注到腹腔内，腹腔部分被塑料片覆盖。从腹部皮肤边缘上方5厘米和35厘米处抽吸大量空气。检测外科医生和灌注师的尿液。检测手术室中在治疗期间用于操作内脏的无菌手套对丝裂霉素C的渗透性。所有样品均通过高效液相色谱法进行分析。
结果
对10例手术的手术室空气和尿液样本分析显示未检测到丝裂霉素C水平。对三种不同类型手套的六项测试显示丝裂霉素C渗透范围为10倍。渗透性最低的手套在90分钟内平均泄漏3.8 ppm。
结论
未证明对外科医生或其他手术室人员有可检测到的安全危害。
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