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Hyperthermic pressurized intraperitoneal aerosol drug delivery system in a large animal model: a feasibility and safety study

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Abstract

Background

We developed a novel drug delivery system called hyperthermic pressurized intraperitoneal aerosol chemotherapy (HPIPAC) that hybridized Hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC). The present study aims to assess the feasibility and safety of HPIPAC system in a large animal survival model.

Methods

Eleven pigs (eight non-survival models and three survival models) were used in the experiment. The heat module in the HPIPAC controller circulates hyperthermic CO2 in a closed-loop circuit and creates gas-based dry intraperitoneal hyperthermia. Three 12 mm trocars were placed on the abdomen. The afferent CO2 tube wound with heat generating coil was inserted into a trocar, and the efferent tube was inserted into another trocar. Heated CO2 was insufflated and circulated in a closed circuit until the intra-abdominal and peritoneal surface temperature reached 42 °C. 100 ml of 5% dextrose in water was nebulized for 5 min and the closed-loop circulation was resumed for 60 min at 42 °C. Tissue biopsies were taken from several sites from the pigs in the survival model.

Results

The average change in core temperature of the pigs was 2.5 ± 0.08 °C. All three pigs displayed no signs of distress, and their vital signs remained stable, with no changes in their diet. In autopsy, inflammatory and fibrotic responses at the biopsy sites were observed without serious pathologic findings.

Conclusions

We successfully proved the feasibility and safety of our novel HPIPAC system in an in-vivo swine survival model.

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Acknowledgements

The HPIPAC System was assembled by Dr Koo Tae Kang from Nextech Co. according to our specifications.

Funding

This study received funding from Seoul National University Bundang Hospital (Grant Nos. SNUBH 02-2017-0049, 14-2018-0004, 14-2019-0004).

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Author notes

  1. Hyung-Ho Kim

    Present address: Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Asan Medical Center, Seoul, Korea

    Sa-Hong Min

  2. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

    Mira Yoo, Duyeong Hwang, So Hyun Kang, Young Suk Park, Sang-Hoon Ahn & Hyung-Ho Kim

  3. Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea

    Eunju Lee

  4. Department of Surgery, Kyung Hee University Hospital At Gangdong, Seoul, Korea

    Sangjun Lee

  5. Department of Surgery, Seongnam Citizens Medical Center, Seongnam, Korea

    Yongjoon Won

  6. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Hyung-Ho Kim

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  1. Sa-Hong Min
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Correspondence to Hyung-Ho Kim.

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Disclosures

Sa-Hong Min, Mira Yoo, Duyeong Hwang, Eunju Lee, So Hyun Kang, Sangjun Lee, Yongjoon Won, Young Suk Park, Sang-Hoon Ahn, Hyung-Ho Kim have no conflicts of interest or financial ties to disclose.

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Min, SH., Yoo, M., Hwang, D. et al. Hyperthermic pressurized intraperitoneal aerosol drug delivery system in a large animal model: a feasibility and safety study. Surg Endosc 38, 2062–2069 (2024). https://doi.org/10.1007/s00464-024-10702-4

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