Laparoscopic cytoreductive surgery and HIPEC in LAMN with small volume of peritoneal disease: a valuable option of treatment for good patient-related experience measures (PREMs)

2021 ◽  
Author(s):  
Caterina Cusumano ◽  
Sébastien Carrere ◽  
Alix Bouillin ◽  
Stéphanie Nougaret ◽  
Lakhdar Khellaf ◽  
...  
Keyword(s):  
Cytoreductive Surgery ◽  
Small Volume ◽  
Peritoneal Disease ◽  
Good Patient

Diagnostic Laparoscopy in Patients With Peritoneal Carcinomatosis Is Safe and Does Not Delay Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

2021 ◽  
pp. 000313482110488
Author(s):  
David N. Hanna ◽  
Muhammad O. Ghani ◽  
Andrew Hermina ◽  
Alexander Mina ◽  
Christina E. Bailey ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Diagnostic Laparoscopy ◽  
Peritoneal Disease ◽  
Cross Sectional ◽  
Comparable Rate ◽  
Gastrointestinal Malignancies ◽  
Intraoperative Complication

Background Outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) among patients with peritoneal carcinomatosis (PC) depend largely on the extent of peritoneal disease. Since PC is not reliably evaluated with cross-sectional imaging, tumor burden is often evaluated with diagnostic laparoscopy (DLS). The aims of this study are to evaluate the safety of DLS in patients with peritoneal disease and determine if DLS delays time to CRS-HIPEC. Methods We performed an institutional retrospective review of 145 patients who underwent CRS-HIPEC between 2013 and 2020. Patients were divided into 2 groups: those who underwent an electively scheduled DLS prior to CRS-HIPEC and those who did not. Intraoperative and postoperative complications associated with DLS were determined from the surgeon’s operative report. Time from diagnosis of PC to CRS-HIPEC was compared between the 2 groups. Results Of the 145 patients available for analysis, 47% (68) underwent DLS and 44% (64) did not. Of all the diagnostic laparoscopies performed, there was 1 (1.5%) intraoperative complication. The duration between diagnosis of peritoneal carcinomatosis and surgery was 4.9 months among patients who underwent DLS prior to CRS-HIPEC and 4.3 months among patients who did not ( P = .79). Conclusion In this retrospective analysis, diagnostic laparoscopy prior to CRS-HIPEC demonstrated a comparable rate of DLS-associated complications compared to other gastrointestinal malignancies and does not prolong time from diagnosis to CRS-HIPEC. Thus, in patients undergoing evaluation for CRS-HIPEC, diagnostic laparoscopy provides significant value in patient selection without incurring perioperative risk or delay in CRS-HIPEC.

scholarly journals The PEritoneal SUrface CAlculator (PESUCA): A new tool to quantify the resected peritoneal surface area after cytoreductive surgery

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Philipp Schredl ◽  
Jan Philipp Ramspott ◽  
Daniel Neureiter ◽  
Klaus Emmanuel ◽  
Tarkan Jäger
Keyword(s):  
Surface Area ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Relative Proportion ◽  
External Validation ◽  
The Body ◽  
Programming Algorithm ◽  
Peritoneal Disease ◽  
Disease Extent ◽  
Peritoneal Surface

AbstractBackgroundThe body surface area (BSA) is taken as a measure for the effective contact area for dosing in hyperthermic intraperitoneal chemotherapy (HIPEC). Currently, the pharmacokinetic effect of the reduced peritoneal surface area (PSA) after cytoreductive surgery (CRS) during HIPEC remains unclear. Here a proprietary software solution (PEritoneal SUrface CAlculator (PESUCA)) to quantify the resected PSA in patients with peritoneal surface malignancies (PSM) undergoing CRS and HIPEC is presented.MethodsThe PESUCA tool was programmed as a desktop and online software solution. The applicability was evaluated in 36 patients. The programming-algorithm is briefly summarized as follows: (1) calculation of BSA, (2) correlation to PSA, (3) calculation of the relative proportion of 40 different anatomical regions to total PSA before CRS, (4) instantaneous input of each resected proportion in the 40 anatomical regions during CRS, and (5) determination of the resected and remaining PSA after CRS.ResultsThe proof of concept revealed a mean PSA of all patients before CRS of 18,741 ± 321 cm2 compared to 13,611 ± 485 cm2 after CRS (p<0.0001). Patients’ supramesocolic and inframesocolic visceral and parietal peritoneal area before and after CRS procedure were quantitatively determined.ConclusionsHere the first tool that enables detailed PSA quantification in patients with PSM undergoing CRS is presented. This makes the software a valuable contribution to ensue more accurate assessment and improved comparability of peritoneal disease extent. Furthermore, after external validation, PESUCA could be the basis for dose adjustment of intraperitoneal chemotherapy regimens based on the remaining PSA after CRS.

Current practice in cytoreductive surgery and HIPEC for metastatic peritoneal disease: Spanish multicentric survey

2018 ◽  
Vol 44 (2) ◽  
pp. 228-236 ◽  
Author(s):  
Rafael Morales-Soriano ◽  
Neus Esteve-Pérez ◽  
Juan José Segura-Sampedro ◽  
Pedro Cascales-Campos ◽  
Pedro Barrios ◽  
...  
Keyword(s):  
Cytoreductive Surgery ◽  
Current Practice ◽  
Peritoneal Disease

Protamine-DNA interaction

1978 ◽  
Vol 36 (2) ◽  
pp. 200-201
Author(s):  
D.P. Bazett-Jones ◽  
F.P. Ottensmeyer
Keyword(s):  
Small Volume ◽  
Double Helix ◽  
Dna Interaction ◽  
Dark Field ◽  
Sperm Head ◽  
Nuclear Proteins ◽  
Field Electron Microscopy ◽  
Dark Field Electron ◽  
Dna Double Helix ◽  
Positively Charged

Dark field electron microscopy has been used for the study of the structure of individual macromolecules with a resolution to at least the 5Å level. The use of this technique has been extended to the investigation of structure of interacting molecules, particularly the interaction between DNA and fish protamine, a class of basic nuclear proteins of molecular weight 4,000 daltons.Protamine, which is synthesized during spermatogenesis, binds to chromatin, displaces the somatic histones and wraps up the DNA to fit into the small volume of the sperm head. It has been proposed that protamine, existing as an extended polypeptide, winds around the minor groove of the DNA double helix, with protamine's positively-charged arginines lining up with the negatively-charged phosphates of DNA. However, viewing protamine as an extended protein is inconsistent with the results obtained in our laboratory.

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