Carpet bombing by metastases
This method was invented in Germany, but only Russia managed not only to master it in full, but also to come up with its own “golden key” to it.
– The essence of the pie-pack method (PIPAC) is to spray a solution of chemotherapy drugs through a special nozzle directly into the abdominal cavity during laparoscopy. This allows you to prevent the appearance of new metastases in the peritoneum, prevents the accumulation of fluid in the abdomen, and in some cases leads to the complete disappearance of existing metastases, – says Vladimir Khomyakov, head of the thoraco-abdominal department of the P. Hertsen Moscow Oncology Research Institute. – At the same time, well-known medicinal antitumor drugs are used, including those produced in Russia. The whole complexity and high cost of the method was not in the medicine, but in the device with which it is sprayed. Our institute has developed its own analogue of the nozzle, which is now manufactured in Russia and therefore this kind of help has become more accessible to our patients.
It must be said that the pai-pack and hi-pack methods (HIPEC – hyperthermic intra-abdominal chemotherapy) are usually used in patients with advanced forms of cancer, often as the only option to save human health. Such a case occurred last Friday. A fairly young 55-year-old man was operated on for peritoneal carcinomatosis, which developed as a result of the progression of stage 3 stomach cancer after previously performed gastric removal surgery. He was laparoscopically injected with a chemotherapy drug and a peritoneal biopsy was taken. This was the second pai-pack session and, compared to the previous laparoscopy, almost all metastases completely disappeared. During the operation, the film crew for the first time observed, thanks to modern telemedicine, the process of spraying a fine aerosol of a chemotherapy drug in the peritoneum. The head of the operational team, V.M. Khomyakov, showed a real metastasis during the examination of the upcoming “battlefield”. He looked like a harmless white star, or a small jellyfish. Harmless because he was already defeated.
– Due to the structure of the nozzle, the drug under pressure turns into a fine suspension and penetrates into all parts of the abdominal cavity like a mist, – continues Dr. Khomyakov.- Thus, uniform treatment of all organs that cancer would threaten with new metastases is achieved.
The operation was successful, according to the surgeon, usually such patients are observed for another two days and can be discharged home.
Congratulations to the patient and the entire team of doctors and nurses of the third table on their successful work!
The press service of the FSBI NMIC of Radiology of the Ministry of Health of Russia.