PIPAC

The PIPAC technique (Pressurized Intraperitoneal Aerosol Chemotherapy) is a chemotherapy that is applied in aerosol form inside the abdominal cavity. It consists of making two small incisions (cuts) in the abdominal wall and with a laparoscopy nebulizer, sprinkling the chemotherapy in form of “fine rain” directly on the zone affected by the tumour, in cases of patients with peritoneal carcinomatosis.

Peritoneal carcinomatosis is a form of dissemination of the tumour of origin (digestive, gynaecologic or of the peritoneum itself) and it expands throughout the abdominal region. It is diagnosed by the presence of tumour nodules in the peritoneal layer. Historically, it has been considered as the terminal phase of the disease; nevertheless, for the past decade, it has been considered a disease localized in the abdominal cavity. Patients that do not respond effectively to conventional systemic chemotherapy and do not fulfil criteria to undergo cytoreductive surgery are candidates to benefit from PIPAC.

One of the important benefits of this new technique is that it is administered in a homogeneous and localized manner on the affected zone, minimizing the adverse effects of the systemic treatments. The clinical results indicate that it can become a highly effective therapy thanks to the control of the adverse effects.

The first application in humans was carried out in 2011 at the Evangelic Hospital of Bielefeld by Prof. Reymond and today, it is still considered an experimental technique. Nevertheless, the studies performed and the clinical results obtained indicate that this technique can become a highly effective treatment because it has been shown to increase the quality of life by the control of the symptoms of the disease in advanced state.

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