medinfoАктуальные проблемы теоретической и клинической медициныActual Problems of Theoretical and Clinical Medicine2790-12892790-1297Казахстанско-Российский медицинский университет10.64854/2790-1289-2025-49-3-10medinfo-782Research ArticleОБЗОР ЛИТЕРАТУРЫREVEWSПРОФЕССИОНАЛЬНАЯ И ЭКОЛОГИЧЕСКАЯ БЕЗОПАСНОСТЬ ПРИ ЛЕЧЕНИИ ПЕРИТОНЕАЛЬНЫХ МЕТАСТАЗОВ МЕТОДОМ ВНУТРИБРЮШИННОЙ АЭРОЗОЛЬНОЙ ХИМИОТЕРАПИЕЙ ПОД ДАВЛЕНИЕМ: ПРЕДВАРИТЕЛЬНЫЙ ОБЗОРOCCUPATIONAL AND ENVIRONMENTAL SAFETY IN THE TREATMENT OF PERITONEAL METASTASES USING THE PRESSURIZED INTRAPERITONEAL AEROSOL CHEMOTHERAPY METHOD: A SCOPING REVIEWhttps://orcid.org/0009-0000-4795-255XБеркембаеваА. Л.BerkembayevaA. L.

Специалист сестринского дела операционного блока

operating room nursing specialist

asemgul_berkembaeva@mail.ruhttps://orcid.org/0009-0000-4859-1637БуркитбаевЖ. К.BurkitbayevZh. K.

д.м.н., Председатель Правления

MD, DMedSc, Chairman of the Board

zhan11@mail.ruhttps://orcid.org/0000-0001-6860-3455ЗайнулинаД. А.ZainulinaJ. А.

MHC, менеджер отдела менеджмента и развития сестринского дела

MHC, manager of the nursing management and development department

djamilya_89@bk.ruhttps://orcid.org/0000-0002-9578-4236КуанышЖ. М.KuanyshZh. M.

MMSPH, главный специалист сектора клинических и фундаментальных исследований, отдел научного менеджмента

MMSPH, chief specialist of the clinical and fundamental research sector, department of scientific management

zhuldyzkuanysh@icloud.comhttps://orcid.org/0000-0002-9578-4236КеримкуловА. К.KerimkulovA. К.

МВА, старший ординатор абдоминальной хирургии

MBA, senior surgeon of abdominal surgery

altay.kerimkulov@gmail.comhttps://orcid.org/0000-0003-0791-4246ДушимоваЗ. Д.DushimovaZ.

к.м.н., доцент кафедры фундаментальной медицины 

MD, PhD, Associate Professor of the Department of Fundamental Medicine

dushimova.zaure@kaznu.edu.kzТОО «Национальный научный онкологический центр»КазахстанLLP «National Research Oncology Center»KazakhstanНАО КазНУ им. Аль-ФарабиКазахстанAl-Farabi Kazakh National UniversityKazakhstan20252509202503139159Copyright © Беркембаева А.Л., Буркитбаев Ж.К., Зайнулина Д.А., Куаныш Ж.М., Керимкулов А.К., Душимова З.Д., 20252025Беркембаева А.Л., Буркитбаев Ж.К., Зайнулина Д.А., Куаныш Ж.М., Керимкулов А.К., Душимова З.Д.Berkembayeva A.L., Burkitbayev Z.K., Zainulina J.А., Kuanysh Z.M., Kerimkulov A.К., Dushimova Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://kazrosmedjournal.krmu.edu.kz/jour/article/view/782

Перитонеальные метастазы представляют собой распространённое проявление прогрессирования злокачественных опухолей различных локализаций. Несмотря на существующие системную терапию и хирургический подход, значительная доля пациентов продолжает сталкиваться с неудовлетворенными клиническими потребностями, низким качеством жизни и неблагоприятным прогнозом. В ответ на эти ограничения в начале 2000-х был разработан новый метод внутрибрюшной аэрозольной химиотерапии под давлением. Вопреки растущему интересу к данному методу, вызывает обеспокоенность потенциальный профессиональный риск для медицинского персонала и окружающей среды, связанный с ингаляционным воздействием аэрозольных форм цитостатиков.

Целью данного обзорного исследования было изучение и обобщение современных данных о профессиональных рисках и мерах безопасности, реализуемых на всех этапах операционного процесса при проведении сеансов внутрибрюшной аэрозольной химиотерапии под давлением для лечения перитонеальных метастазов. На основе существующих данных разработать клинические рекомендации по обеспечению защиты медицинских сотрудников и окружающей среды.

Методы и материалы

Методы и материалы. Соответствующие публикации были найдены путем систематического поиска в базах данных PubMed, Scopus и eLibrary. Критериями включения были публикации, описывающие метод внутрибрюшной аэрозольной химиотерапии под давлением, меры индивидуальной и коллективной защиты, а также рекомендации по организации безопасной работы с цитостатическими аэрозолями в условиях операционной.

Результаты

Результаты. В результате поиска было выявлено 185 публикаций, из которых 37 соответствовали критериям включения. Включенные исследования в основном состояли из отчетов наблюдений, экспериментального моделирования и институциональных руководств. Ключевые меры безопасности включали использование закрытых систем подачи аэрозолей, высокоэффективной вентиляции, средств индивидуальной защиты и стандартизированных протоколов дезактивации. Данные о долгосрочном профессиональном риске были ограничены, но большинство исследований подчеркивали необходимость строгого соблюдения правил безопасности.

Выводы

Выводы. Данный обзор вносит вклад в доказательную базу, подтверждающую безопасность труда и окружающей среды при проведении сеансов внутрибрюшной аэрозольной химиотерапии под давлением. Обобщенные результаты могут быть использованы для адаптации и стандартизации многоуровневых стратегий защиты и протоколов обучения медицинских сотрудников, тем самым минимизируя риски для персонала и рабочей среды.

Peritoneal metastases are a common manifestation of malignant tumor progression in various locations. Despite the availability of systemic therapy and surgical approaches, many patients continue to face unmet clinical needs, reduced quality of life, and unfavorable outcomes. In response to these limitations, pressurized intraperitoneal aerosol chemotherapy was developed in the early 2000s. While this technique has generated increasing clinical interest, concerns remain regarding potential occupational and environmental risks, particularly due to aerosolized exposure to cytotoxic agents.

This scoping review aimed to explore and summarize current evidence on occupational risks and safety measures implemented during pressurized intraperitoneal aerosol chemotherapy sessions for the treatment of peritoneal metastases. Based on available data, we also sought to identify clinical recommendations to ensure the protection of healthcare personnel and the operating room environment.

Materials and methods

Materials and methods. Relevant publications were identified through a systematic search of PubMed, Scopus, and eLibrary databases. Eligible studies described the pressurized intraperitoneal aerosol chemotherapy method, personal and collective protective measures, or organizational recommendations for safe handling of cytostatic aerosols in the surgical setting.

Results

Results. The search identified 185 publications, of which 37 met the inclusion criteria. The included studies mainly consisted of observational reports, experimental simulations, and institutional guidelines. Key safety measures included the use of closed aerosol delivery systems, high-efficiency ventilation, personal protective equipment, and standardized decontamination protocols. Evidence of long-term occupational risk was limited, but most studies emphasized the necessity of strict adherence to safety procedures.

Conclusions

Conclusions. This review contributes to the evidence base supporting the occupational and environmental safety of pressurized intraperitoneal aerosol chemotherapy sessions. The synthesized findings can inform the adaptation and standardization of multilayered protection strategies and training protocols for healthcare workers, thereby minimizing risks to staff and the operating environment.

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The authors declare that there are no conflicts of interest present.