Pressurized intraperitoneal aerosol chemotherapy (PIPAC): updated systematic review using the IDEAL framework
Alice Baggaley, Guillaume B. R. C. Lafaurie, Sophia Tate, Piers R. Boshier, Amy Case, Susan Prosser, Jared Torkington, Sadie Jones, Sarah Gwynne, Christopher J. Peters
Abstract
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a surgical innovation deployed to treat peritoneal metastases. Traditionally, peritoneal metastases have been treated with systemic chemotherapy, but this approach is limited by poor peritoneal perfusion. Intra-abdominal chemotherapy in the form of heated lavage (hyperthermic intraperitoneal chemotherapy (HIPEC)) is currently used alongside cytoreductive surgery. The use of aerosolized agents in a laparoscopic setting was first described in 2000 in a swine model1; since then, a number of PIPAC studies have been reported. The IDEAL framework2 provides recommendations for the design, development, and reporting of studies for novel surgical interventions (Table 1). It recommends that innovations move through stages (idea, development, exploration, assessment, and long-term studies).