OPEN TECHNIQUE OF HYPERTHERMIC INTRAPERITONEAL CHEMOPERFUSION IN TREATMENT OF PERITONEAL CARCINOMATOSIS IN RATS WITH ASCITIC OVARIAN TUMOR

Abstract

For the first time comparative study of open and closed techniques of hyperthermic intraperitoneal chemoperfusion (HIPEC) in terms of safety and efficacy was performed in a rat model of ascetic ovarian cancer transplanted intraperitoneally. Original device and implantation technique of the device into peritoneal cavity were developed and used in the study. All animals after tumor implantation were randomized into 4 groups: 1 - control, intraperitoneal administration of 0.5 ml of saline (n=19); 2 - closed HIPEC with cisplatin, 20 mg/ kg (n=15); 3 - open HIPEC with cisplatin, 16 mg/kg (n=16); 4 - open HIPEC with mitomycin C (n=10). In preliminary stage while working out the original open technique of HIPEC we established that it requires dose reduction for cisplatin from 20 to 16 mg/kg compared to closed technique of HIPEC. We didn't find significant difference between groups 1, 2 and 3 in terms of number of postoperative complications. According to the results of analysis of body weight changes in postoperative period open HIPEC was worse tolerated compared to close HIPEC. Median survival of rats in group 2 was 53 days which was significantly higher compared to median survival in group 2-25 days (p=0,044). Open HIPEC with mitomycin C turned out to be less effective than open HIPEC with cis-platin but equally effective compared to closed HIPEC with cisplatin. However this is preliminary result and more rats have to be included in group 4 in order to make confident conclusion. Overall open HIPEC with cisplatin in accordance with suggested technique seem to be more promising than closed HIPEC in terms of improving outcomes of patients with peritoneal carcinomatosis.