OCCUPATIONAL AND ENVIRONMENTAL SAFETY IN THE TREATMENT OF PERITONEAL METASTASES USING THE PRESSURIZED INTRAPERITONEAL AEROSOL CHEMOTHERAPY METHOD: A SCOPING REVIEW

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. 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. 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. 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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