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Stellenwert der PIPAC bei fortgeschrittener peritonealer Metastasierung

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Peritoneale Tumoren und Metastasen

Zusammenfassung

Die Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) bietet neben der systemischen Chemotherapi, sowie der zytoreduktiven Chirurgie (CRS) und der hyperthermen intraperitonealen Chemotherapie (HIPEC) eine neue Modalität in der Therapie der Peritonealkarzinose. Die PIPAC kann sowohl bei gastrointestinalen als auch bei gynäkologischen Tumoren angewendet werden. Sie beginnt mit einer diagnostischen Laparoskopie, welche die Möglichkeit bietet, eine Spülzytologie des Aszites oder Peritonealbiopsien zu entnehmen. Anschließend wird über 30 min die Chemotherapie als Aerosol verabreicht. Im Gegensatz zur CRS/HIPEC ist dieses Verfahren deutlich weniger invasiv und kann repetitiv angewendet werden. Dies erlaubt es, durch regelmäßige Tumorbiopsien das Ansprechen der Therapie zu objektivieren. Da die PIPAC keine Resektionsphase beinhaltet, muss sie nach wie vor als palliative Therapieoption eingestuft und indiziert werden. Somit ist dieses Therapiekonzept auch bei deutlich fortgeschrittener Krankheit anwendbar. Die hohen Ansprechraten von 60–80 % geben Hoffnung, das Überleben von Patienten mit fortgeschrittener Peritonealkarzinose verbessern zu können.

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Authors and Affiliations

  1. Universität Zürich, Klinik für Viszeral- und Transplantationschirurgie, Rämistrasse 100, 8091, Zürich, Deutschland

    Prof. Dr. med. K. Lehmann & Dr. med. L. Roth

  2. Abteilung Allgemeine und Molekulare Pathologie und Pathologische Anatomie, Institut für Pathologie und Neuropathologie der Eberhard Karls Universität Tübingen, Liebermeisterstraße 8, 72076, Tübingen, Deutschland

    Dr. med. W. Solaß

  3. Ruhr Universität Bochum, Marien Hospital Herne, Universitäts-Frauenklinik der, Hölkeskampring 40, 44623, Herne, Deutschland

    Prof. Dr. med. C. Tempfer

  4. Universitätsklinikum Tübingen, Klinik für Allgemeine, Viszeral- und ­Transplantationschirurgie, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland

    Prof. Dr. med. M. A. Reymond

Authors
  1. Prof. Dr. med. K. Lehmann
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  2. Dr. med. W. Solaß
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  3. Dr. med. L. Roth
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  4. Prof. Dr. med. C. Tempfer
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  5. Prof. Dr. med. M. A. Reymond
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Corresponding authors

Correspondence to K. Lehmann , W. Solaß , L. Roth , C. Tempfer or M. A. Reymond .

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Editors and Affiliations

  1. Charité Campus Virchow-Klinikum, Berlin, Deutschland

    Beate Rau

  2. Krankenhaus Barmherzige Brüder, Regensburg, Deutschland

    Pompiliu Piso

  3. Universitätsklinikum Tübingen, Tübingen, Deutschland

    Alfred Königsrainer

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Lehmann, K., Solaß, W., Roth, L., Tempfer, C., Reymond, M.A. (2018). Stellenwert der PIPAC bei fortgeschrittener peritonealer Metastasierung. In: Rau, B., Piso, P., Königsrainer, A. (eds) Peritoneale Tumoren und Metastasen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54500-3_27

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  • DOI: https://doi.org/10.1007/978-3-662-54500-3_27

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-54499-0

  • Online ISBN: 978-3-662-54500-3

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