Pressurized intraperitoneal aerosol chemotherapy (PIPAC)

Patients with peritoneal carcinomatosis have a poor prognosis despite multimodal treatment with surgery and chemotherapy. Cytoreductive surgery is the only curative option for the treatment of carcinomatosis but only a minority of patients are eligible for surgical treatment. For non-resectable peritoneal carcinomatosis chemotherapy is the only possible option with limited effect on the peritoneal metastases due to poor vascularization and low penetration of the drug. Pressurized Intra Peritoneal Aerosol Chemotherapy (PIPAC) is a new, minimally invasive method using a laparoscopy to deliver chemotherapy in the form of pressurized aerosol into the abdomen, allowing for better distribution of the drug in the abdominal cavity and deeper penetration of the drug. PIPAC is a technically feasible and safe procedure useful as a treatment option for isolated peritoneal carcinomatosis of various origins. Promising results have been published regarding the treatment of peritoneal metastases of all origin wits PIPAC. There are many ongoing propective clinical trials evaluating the ontological efficacy of PIPAC in multiple indications with various drugs.