Roussin Fanny, Taibi Abdelkader, Canal-Raffin Mireille, Cantournet Lucile, Durand-Fontanier Sylvaine, Druet-Cabanac Michel, El Balkhi Souleiman, Maillan Gaëlle
Pharmacy Department, Dupuytren Limoges University Hospital, France.
Digestive Surgery Department, Dupuytren Limoges University Hospital, France; University Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France.
Eur J Surg Oncol. 2021 Nov;47(11):2939-2947. doi: 10.1016/j.ejso.2021.05.020. Epub 2021 May 19.
Electrostatic precipitation pressurized intraperitoneal aerosol chemotherapy (ePIPAC) is a novel approach for intraperitoneal drug delivery. As ePIPAC using cisplatin and doxorubicin is performed in an operating room, the challenge is to safely deliver the chemotherapeutic aerosol intraperitoneally while preventing exposure to healthcare workers. The objective of this study was to describe cisplatin and doxorubicin workplace environmental contamination and healthcare worker exposure during ePIPAC.
Antineoplastic drugs concentrations of cisplatin and doxorubicin were measured in wipe samples from the operating room, and urine samples were collected from healthcare workers. The air samples were collected in order to detect Cisplatin contamination. Cisplatin was analysed by inductively coupled plasma-mass spectrometry and doxorubicin by ultra-high-performance liquid chromatography coupled with tandem mass spectrometry.
No trace of cisplatin was found in the air. Cisplatin and doxorubicin were detected on the operating room floor, surfaces, devices and personal protective equipment even after a cleaning protocol. No traces of cisplatin or doxorubicin were found in the urine samples.
In this study, no internal contamination was found in the ePIPAC surgical team even after implementing two successive ePIPAC procedures. These results showed the effectiveness of the individual and collective protective measures applied. However, the cleaning procedure during ePIPAC should be respected to limit environmental exposure to chemotherapy to cisplatin and doxorubicin during ePIPAC.
静电沉淀加压腹腔内气溶胶化疗（ePIPAC）是一种新型的腹腔给药方法。由于使用顺铂和阿霉素的ePIPAC操作在手术室进行，面临的挑战是在防止医护人员暴露的同时安全地将化疗气溶胶注入腹腔。本研究的目的是描述ePIPAC过程中顺铂和阿霉素在工作场所的环境污染及医护人员的暴露情况。
检测手术室擦拭样本中顺铂和阿霉素的抗肿瘤药物浓度，并收集医护人员的尿液样本。采集空气样本以检测顺铂污染情况。顺铂采用电感耦合等离子体质谱法分析，阿霉素采用超高效液相色谱-串联质谱法分析。
空气中未发现顺铂痕迹。即使经过清洁流程，在手术室地面、表面、设备及个人防护装备上仍检测到顺铂和阿霉素。尿液样本中未发现顺铂或阿霉素痕迹。
在本研究中，即使连续实施两次ePIPAC手术，ePIPAC手术团队也未发现体内污染情况。这些结果表明所采取的个人和集体防护措施是有效的。然而，应遵守ePIPAC期间的清洁程序，以限制ePIPAC期间化疗药物顺铂和阿霉素对环境的暴露。
