Department of General and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
National Center for Pleura and Peritoneum (NCPP), National Tumor Center SW Germany, Tübingen, Germany.
Surg Endosc. 2022 Oct;36(10):7848-7858. doi: 10.1007/s00464-022-09525-y. Epub 2022 Aug 29.
We tested the feasibility of ultrasound technology for generating pressurized intraperitoneal aerosol chemotherapy (usPIPAC) and compared its performance vs. comparator (PIPAC).
A piezoelectric ultrasound aerosolizer (NextGen, Sinaptec) was compared with the available technology (Capnopen, Capnomed). Granulometry was measured for water, Glc 5%, and silicone oil using laser diffraction spectrometry. Two- and three-dimensional (2D and 3D) spraying patterns were determined with methylene blue. Tissue penetration of doxorubicin (DOX) was measured by fluorescence microscopy in the enhanced inverted Bovine Urinary Bladder model (eIBUB). Tissue DOX concentration was measured by high-performance liquid chromatography (HPLC).
The droplets median aerodynamic diameter was (usPIPAC vs. PIPAC): H0: 40.4 (CI 10-90%: 19.0-102.3) vs. 34.8 (22.8-52.7) µm; Glc 5%: 52.8 (22.2-132.1) vs. 39.0 (23.7-65.2) µm; Silicone oil: 178.7 (55.7-501.8) vs. 43.0 (20.2-78.5) µm. 2D and 3D blue ink distribution pattern of usPIPAC was largely equivalent with PIPAC, as was DOX tissue concentration (usPIPAC: 0.65 (CI 5-95%: 0.44-0.86) vs. PIPAC: 0.88 (0.59-1.17) ng/ml, p = 0.29). DOX tissue penetration with usPIPAC was inferior to PIPAC: usPIPAC: 60.1 (CI 5.95%: 58.8-61.5) µm vs. PIPAC: 1172 (1157-1198) µm, p < 0.001). The homogeneity of spatial distribution (top, middle and bottom of the eIBUB) was comparable between modalities.
usPIPAC is feasible, but its performance as a drug delivery system remains currently inferior to PIPAC, in particular for lipophilic solutions.
我们测试了超声技术产生加压腹腔内气溶胶化疗（usPIPAC）的可行性，并将其性能与对照（PIPAC）进行了比较。
使用压电超声雾化器（NextGen，Sinaptec）与现有技术（Capnopen，Capnomed）进行比较。使用激光衍射光谱法测量水、Glc5%和硅油的粒度。使用亚甲蓝测定二维（2D）和三维（3D）喷雾模式。通过荧光显微镜在增强型倒置牛膀胱模型（eIBUB）中测量多柔比星（DOX）的组织穿透性。通过高效液相色谱法（HPLC）测量组织中的 DOX 浓度。
液滴的中空气动力学直径为（usPIPAC 与 PIPAC）：H0：40.4（CI10-90%：19.0-102.3）与 34.8（22.8-52.7）μm；Glc5%：52.8（22.2-132.1）与 39.0（23.7-65.2）μm；硅油：178.7（55.7-501.8）与 43.0（20.2-78.5）μm。usPIPAC 的 2D 和 3D 蓝色墨水分布模式与 PIPAC 基本相当，DOX 组织浓度也是如此（usPIPAC：0.65（CI5-95%：0.44-0.86）与 PIPAC：0.88（0.59-1.17）ng/ml，p=0.29）。与 PIPAC 相比，usPIPAC 的 DOX 组织穿透性较差：usPIPAC：60.1（CI5.95%：58.8-61.5）μm 与 PIPAC：1172（1157-1198）μm，p<0.001）。两种模式的空间分布均匀性（eIBUB 的顶部、中部和底部）相当。
usPIPAC 是可行的，但作为一种药物输送系统，其性能目前仍逊于 PIPAC，特别是对于亲脂性溶液。
