Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey

Eur J Surg Oncol. 2015 Oct;41(10):1361-7. doi: 10.1016/j.ejso.2015.07.012. Epub 2015 Jul 29.

Abstract

Background: Over the last two decades, many surgical teams have developed programs to treat peritoneal carcinomatosis with extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Currently, there are no specific recommendations for HIPEC procedures concerning environmental contamination risk management, personal protective equipment (PPE), or occupational health supervision.

Methods: A survey of the institutional practices among all French teams currently performing HIPEC procedures was carried out via the French network for the treatment of rare peritoneal malignancies (RENAPE).

Results: Thirty three surgical teams responded, 14 (42.4%) which reported more than 10 years of HIPEC experience. Some practices were widespread, such as using HIPEC machine approved by the European Community (100%), individualized or centralized smoke evacuation (81.8%), "open" abdominal coverage during perfusion (75.8%), and maintaining the same surgeon throughout the procedure (69.7%). Others were more heterogeneous, including laminar flow air circulation (54.5%) and the provision of safety protocols in the event of perfusate spills (51.5%). The use of specialized personal protective equipment is ubiquitous (93.9%) but widely variable between programs.

Conclusion: Protocols regarding cytoreductive surgery/HIPEC and the associated professional risks in France lack standardization and should be established.

Keywords: HIPEC; Intraperitoneal chemotherapy; Peritoneal carcinomatosis; Personal protective equipment; Practices survey; Professional risks.

Publication types

  • Multicenter Study

MeSH terms

  • Air Conditioning / methods*
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma / therapy*
  • Cytoreduction Surgical Procedures / methods*
  • France
  • Humans
  • Hyperthermia, Induced / methods*
  • Infusions, Parenteral / methods*
  • Occupational Health
  • Peritoneal Neoplasms / therapy*
  • Personal Protective Equipment / statistics & numerical data*
  • Practice Patterns, Physicians'*
  • Risk Management
  • Smoke
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents
  • Smoke