Pleura and Peritoneum最新文献

{"title":"Enhanced recovery after surgery (ERAS) in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC): a cross-sectional survey.","authors":"Geetu Bhandoria,&nbsp;Sohan Lal Solanki,&nbsp;Mrugank Bhavsar,&nbsp;Kalpana Balakrishnan,&nbsp;Cherukuri Bapuji,&nbsp;Nitin Bhorkar,&nbsp;Prashant Bhandarkar,&nbsp;Sameer Bhosale,&nbsp;Jigeeshu V Divatia,&nbsp;Anik Ghosh,&nbsp;Vikas Mahajan,&nbsp;Abraham Peedicayil,&nbsp;Praveen Nath,&nbsp;Snita Sinukumar,&nbsp;Robin Thambudorai,&nbsp;Ramakrishnan Ayloor Seshadri,&nbsp;Aditi Bhatt","doi":"10.1515/pp-2021-0117","DOIUrl":"https://doi.org/10.1515/pp-2021-0117","url":null,"abstract":"<p><strong>Objectives: </strong>Enhanced recovery after surgery (ERAS) protocols have been questioned in patients undergoing cytoreductive surgery (CRS) with/without hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies. This survey was performed to study clinicians' practice about ERAS in patients undergoing CRS-HIPEC.</p><p><strong>Methods: </strong>An online survey, comprising 76 questions on elements of prehabilitation (n=11), preoperative (n=8), intraoperative (n=16) and postoperative (n=32) management, was conducted. The respondents included surgeons, anesthesiologists, and critical care specialists.</p><p><strong>Results: </strong>The response rate was 66% (136/206 clinicians contacted). Ninety-one percent of respondents reported implementing ERAS practices. There was encouraging adherence to implement the prehabilitation (76-95%), preoperative (50-94%), and intraoperative (55-90%) ERAS practices. Mechanical bowel preparation was being used by 84.5%. Intra-abdominal drains usage was 94.7%, intercostal drains by 77.9% respondents. Nasogastric drainage was used by 84% of practitioners. The average hospital stay was 10 days as reported by 50% of respondents. A working protocol and ERAS checklist have been designed, based on the results of our study, following recent ERAS-CRS-HIPEC guidelines. This protocol will be prospectively validated.</p><p><strong>Conclusions: </strong>Most respondents were implementing ERAS practices for patients undergoing CRS-HIPEC, though as an extrapolation of colorectal and gynecological guidelines. The adoption of postoperative practices was relatively low compared to other perioperative practices.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 3","pages":"99-111"},"PeriodicalIF":1.8,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2021-0117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontmatter","authors":"","doi":"10.1515/pp-2021-frontmatter2","DOIUrl":"https://doi.org/10.1515/pp-2021-frontmatter2","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"163 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77487053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ISSPP PIPAC database: design, process, access, and first interim analysis.","authors":"Michael Bau Mortensen,&nbsp;Olivier Glehen,&nbsp;Philipp Horvath,&nbsp;Martin Hübner,&nbsp;Kim Hyung-Ho,&nbsp;Alfred Königsrainer,&nbsp;Marc Pocard,&nbsp;Marc Andre Reymond,&nbsp;Jimmy So,&nbsp;Claus Wilki Fristrup","doi":"10.1515/pp-2021-0108","DOIUrl":"https://doi.org/10.1515/pp-2021-0108","url":null,"abstract":"<p><strong>Objectives: </strong>Several trials have documented the favorable safety profile, and promising clinical results of pressurized intraperitoneal aerosol chemotherapy (PIPAC) directed treatment in different types of peritoneal malignancies. However, until the results of randomized trials are available, the quality of documentation and acceptance by the users may be improved through a worldwide registry. The International Society for the Study of Pleura and Peritoneum (www.ISSPP.org) facilitated this process by creating a dedicated focus group and providing the funding needed for the creation and implementation of an international database. This article describes the design and the journey of establishing this international database and the first, preliminary results from the ISSPP PIPAC online database.</p><p><strong>Methods: </strong>In 2019 the ISSPP PIPAC Registry Group started to create a database with a minimal dataset relevant to many diseases and applicable in different framework conditions. The task was divided into three phases including design, testing, implementation, protocol, handbook, legal requirements, as well as registry rules and bylaws for the registry group.</p><p><strong>Results: </strong>The ISSPP PIPAC online database has six key elements (patient, consent, treatment, complications, response evaluation and follow-up). Following design, testing and implementation the database was successfully launched in June 2020. Ten institutions reported on 459 PIPAC procedures in 181 patients during the first 6 months, and the recorded data were comparable to the present literature.</p><p><strong>Conclusions: </strong>A new international multicenter PIPAC database has been developed, tested and implemented under the auspices of ISSPP. The database is accessible through the ISSPP website (www.ISSPP.org), and PIPAC institutions worldwide are highly encouraged to participate.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 3","pages":"91-97"},"PeriodicalIF":1.8,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2021-0108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of procalcitonin and pentraxin-3 as early biomarkers for differential diagnosis of pleural effusions.","authors":"Anita Sharma,&nbsp;Apurva Agrawal,&nbsp;Girish Sindhwani,&nbsp;Ashish Sharma,&nbsp;Sojit Tomo,&nbsp;Jaykaran Charan,&nbsp;Dharmveer Yadav,&nbsp;Praveen Sharma","doi":"10.1515/pp-2021-0111","DOIUrl":"https://doi.org/10.1515/pp-2021-0111","url":null,"abstract":"<p><strong>Objectives: </strong>Pleural effusion, defined as an abnormal accumulation of fluid in pleural space, can be of two types: transudative and exudative. The primary aim of the study was to assess the predictive accuracy of procalcitonin (PCT) and pentraxin-3 (PTX-3) in comparison to other biochemical markers such as C-reactive protein (CRP), and adenosine deaminase (ADA) in the differential diagnosis of pleural effusions.</p><p><strong>Methods: </strong>A cross-sectional analytical study was conducted on patients with pleural effusion. Multiple comparisons and receiver-operating characteristics (ROC) analyses were made to evaluate the diagnostic significance of biochemical markers.</p><p><strong>Results: </strong>Sixty-six patients with exudative pleural effusion classified as malignant, tuberculous, and parapneumonic effusions (malignant pleural effusion [MPE], tuberculous [TPE], and parapneumonic [PPE]) were included. Significant differences in pleural fluid levels in both PCT (p-value: 0.001) and PTX-3(p-value: 0.001), as well as serum levels of PCT (p-value: 0.001), were observed between the three groups. ROC analysis showed both PTX-3 and PCT having favorable discrimination ability with high sensitivity (≥90%) and specificity to predict PPE from TPE and MPE.</p><p><strong>Conclusions: </strong>Evaluation of serum and pleural fluid PCT and levels of PTX-3 in the pleural fluid may be used as an early biomarker to differentiate the etiology of pleural effusion.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 2","pages":"83-90"},"PeriodicalIF":1.8,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2021-0111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39114232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasogastric- vs. percutaneous gastrostomy tube for prophylactic gastric decompression after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.","authors":"Job P van Kooten,&nbsp;Nadine L de Boer,&nbsp;Marjolein Diepeveen,&nbsp;Cornelis Verhoef,&nbsp;Jacobus W A Burger,&nbsp;Alexandra R M Brandt-Kerkhof,&nbsp;Eva V E Madsen","doi":"10.1515/pp-2021-0107","DOIUrl":"https://doi.org/10.1515/pp-2021-0107","url":null,"abstract":"<p><strong>Objectives: </strong>Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with postoperative gastroparesis and ileus. In 2015, our practice shifted from using percutaneous gastrostomy tubes (PGT), to nasogastric tubes (NGT) for prophylactic gastric decompression after CRS-HIPEC. This study aimed to compare these methods for length of stay (LOS) and associated complications.</p><p><strong>Methods: </strong>Patients that underwent CRS-HIPEC for peritoneal metastases from colorectal cancer between 2014 and 2019 were included. Cases were grouped based on receiving NGT or PGT postoperatively. Multivariable linear regression determined the independent effect of decompression method on LOS, thereby adjusting for confounders.</p><p><strong>Results: </strong>In total, 179 patients were included in the analyses. Median age was 64 years [IQR:54-71]. Altogether, 135 (75.4%) received a NGT and 44 (24.6%) received a PGT. Gastroparesis occurred significantly more often in the PGT group (18.2 vs. 7.4%, p=0.039). Median LOS was significantly shorter for patients with a NGT (15 [IQR:12-19] vs. 18.5 [IQR:17-25.5], p<0.001). PGT was independently associated with longer LOS in multivariable analysis (Beta=4.224 [95%CI 1.243-7.204]). There was no difference regarding aspiration, pneumonia and postoperative mortality between groups.</p><p><strong>Conclusions: </strong>NGT should be preferred over PGT for gastric decompression after CRS-HIPEC as it is associated with fewer gastroparesis and shorter LOS.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 2","pages":"57-65"},"PeriodicalIF":1.8,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2021-0107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39114229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of oxaliplatin penetration into ovaries of patients treated with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases of colorectal and appendiceal origin using mass spectrometry imaging.","authors":"Marion Larroque,&nbsp;Sandra Mounicou,&nbsp;Olivia Sgarbura,&nbsp;Carine Arnaudguilhem,&nbsp;Lucie Rebel,&nbsp;Cristina Leaha,&nbsp;Pierre-Arnaud Faye,&nbsp;Christine Enjalbal,&nbsp;François Quénet,&nbsp;Brice Bouyssiere,&nbsp;Sébastien Carrere","doi":"10.1515/pp-2020-0149","DOIUrl":"https://doi.org/10.1515/pp-2020-0149","url":null,"abstract":"<p><strong>Objectives: </strong>Platinum salts are commonly used in hyperthermic intraperitoneal chemotherapy (HIPEC) for digestive tract cancer treatment. During HIPEC with oxaliplatin for peritoneal metastases (PMs) treatment, the ovaries are directly exposed to the drug, questioning about ovarian resection and the potential impact of the drug on ovarian functionality, especially in young women of childbearing age. The goal of this work is to understand unwanted damages to the ovaries during HIPEC therapy by the determination of the concentration and distribution of platinum in ovaries in order to address its potential toxicity.</p><p><strong>Methods: </strong>Mass spectrometry imaging techniques, matrix-assisted laser desorption ionization mass spectrometry (MALDI-MS) and laser ablation inductively coupled plasma mass spectrometry (LA-ICP MS), were used to study the penetration of oxaliplatin in ovaries after HIPEC treatment.</p><p><strong>Results: </strong>MALDI-MS allowed the localization of an oxaliplatin-derivative (<i>m/z</i> 456.2) at the periphery of the ovaries. The quantitative LA-ICP MS maps confirmed the localization of elemental platinum as well as in the central part of ovaries from patients who received a previous platinum salt-based chemotherapy.</p><p><strong>Conclusions: </strong>LA-ICP MS images showed that platinum diffusion was extended in cases of previous systemic treatment, questioning about platinum derivatives gonado-toxicity when combining the two treatments.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 2","pages":"67-74"},"PeriodicalIF":1.8,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39114230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, clinical characteristics, and outcome of pleural effusions in ovarian cancer.","authors":"José M Porcel,&nbsp;Paola Murata,&nbsp;Laura Porcel,&nbsp;Silvia Bielsa,&nbsp;Marina Pardina,&nbsp;Antonieta Salud","doi":"10.1515/pp-2020-0152","DOIUrl":"https://doi.org/10.1515/pp-2020-0152","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence, clinical characteristics and prognosis of pleural effusions (PEs) associated with ovarian cancer (OC) have seldom been addressed systematically, as in the current investigation.</p><p><strong>Methods: </strong>All records of consecutive women with a newly diagnosed OC in our institution over a 13-year period were retrospectively reviewed. Features of PEs on CT scans, pleural fluid analyses, need for definitive therapy of PEs, and the influence of PEs on the overall survival (OS) and progression-free survival (PFS) were evaluated.</p><p><strong>Results: </strong>PEs were observed in 81 (43%) of 189 women with OC, either at presentation of cancer (55 patients) or during the course of the disease (26 patients). The causes of PEs were malignancy (55.5%), unknown (37%), or surgery-related (7.4%). The sensitivity of the cytologic diagnosis of malignant PEs was 79.1%. Sixty percent of malignant PEs required pleurodesis or indwelling pleural catheters for symptomatic relief. The presence of ascites strongly predicted PE development (odds ratio 43.2). Women with PEs fared much worse compared with those without PEs, in terms of OS (26.7 vs. 90.4 months), PFS (9.8 vs. 55.3 months) and tumor recurrences (86.4 vs. 43%). In multivariate analyses, PE remained as a relevant independent variable associated with poor outcome (hazard ratio 9.73 for OS, and 3.87 for PFS). Notably, PEs small enough to preclude tapping, and thus of unknown origin, had a similar bad prognosis as malignant PEs.</p><p><strong>Conclusions: </strong>OC patients with PEs experience decreased survival, including those with trace effusions not amenable to tapping.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 2","pages":"75-81"},"PeriodicalIF":1.8,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39114231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trace amounts of irinotecan found in the blood of a surgeon after performing HIPEC: what does it imply?","authors":"Wim Ceelen","doi":"10.1515/pp-2021-0113","DOIUrl":"10.1515/pp-2021-0113","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 2","pages":"47-48"},"PeriodicalIF":1.8,"publicationDate":"2021-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39113799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the blood of a surgeon performing HIPEC contaminated by irinotecan, its major metabolites and platinum compounds?","authors":"Guillaume Saint-Lorant,&nbsp;Simon Rodier,&nbsp;Jean-Marc Guilloit,&nbsp;Sophie Ndaw,&nbsp;Mathieu Melczer,&nbsp;Stéphanie Lagadu,&nbsp;Agnès Palix,&nbsp;Raphaël Delépée","doi":"10.1515/pp-2020-0141","DOIUrl":"https://doi.org/10.1515/pp-2020-0141","url":null,"abstract":"<p><strong>Objectives: </strong>Hyperthermic intraperitoneal chemotherapy (HIPEC) is a beneficial surgical technique for patients, but the surgeons are being exposed to cytotoxic drugs. Few biomonitoring studies were led on blood samples in the context of HIPEC. This study aimed to evaluate the surgeon's plasmatic and red blood cell (RBC) contamination by irinotecan, two of its major metabolites and platinum compounds.</p><p><strong>Methods: </strong>HIPEC procedures performed using the coliseum techniques were observed between September 2015 and April 2018 in a French comprehensive cancer center. Irinotecan and its metabolites SN-38 and APC were dosed by UHPLC with a limit of quantification determined at 50 pg/mL. Platinum compounds were dosed by inductively coupled plasma mass spectrometry with a limit of quantification determined at 16 pg/mL.</p><p><strong>Results: </strong>Despite collective and personal protective equipment, 80% of plasma samples were contaminated by irinotecan and 33% by platinum compounds out of 21. The results showed that the surgeon was contaminated after HIPEC and even after a period of HIPEC inactivity. Nineteen percent of plasmatic samples and 45% of RBC samples were contaminated by SN-38, the active metabolite of irinotecan. APC was only found in some RBC samples (33%).</p><p><strong>Conclusions: </strong>Even if this study shows blood contamination by irinotecan, two of its major metabolites (including active SN-38) and platinum compounds both in the plasma and RBC of a surgeon performing the HIPEC procedures, further studies should be performed to confirm these results. Additional studies should be carried out to further investigate the contamination in the context of HIPEC and more broadly in the hospital.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"6 2","pages":"49-55"},"PeriodicalIF":1.8,"publicationDate":"2021-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39113800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontmatter","authors":"","doi":"10.1515/pp-2021-frontmatter1","DOIUrl":"https://doi.org/10.1515/pp-2021-frontmatter1","url":null,"abstract":"","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"39 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90876720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}