M. Peterson1, E. MCabe-Lankford1, B. McCarthy1, N. Levi-Polyachenko1 1Wake Forest University School Of Medicine,Winston-Salem, NC, USA
Introduction:
Peritoneal carcinomatosis (PC) is a late stage presentation of multiple gastrointestinal and gynecologic organ malignancies. In the past three decades, surgical debulking combined with locoregional administration of chemotherapy in a procedure termed hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a promising treatment strategy, extending survival times and, in some cases, offering a cure for this previously uniformly terminal condition. Owing to its relative newness, HIPEC remains the subject of extensive research to optimize drug regimens and technique as well as to design chemotherapeutic agents specifically for intraperitoneal use. Mouse models for study of peritoneal carcinomatosis (PC) treatment have been validated as translatable and inexpensive, however, technical description of intraperitoneal perfusion procedures in mice is lacking in published literature. We present techniques for closed abdomen perfusion with a single or double outflow port and open abdomen (“coliseum”) perfusion mimicking hyperthermic intraperitoneal chemotherapy (HIPEC).
Methods:
Female Balb/C mice underwent 30-minute perfusion using Masterflex L/S Digital Pump, XX8000004 Head, 96400-15 tubing as pump system. For closed abdomen perfusion with both single and double outflow, small incisions were made in upper and lower abdomens and inflow and outflow tubes were inserted and secured with suture to perfuse at 50 mL/hr (Fig. 1 A, B). For open abdomen perfusion, vertical midline incision was made to expose abdominal cavity and edges of incision were secured to ring stand to create a “coliseum” to perfuse at 50-100 mL/hr (Fig. 1 C).
Results:
Closed perfusion with single outflow: Of 12 mice, 11 survived to 24-hour post-operative end-point with 1 intra-op death. Intraoperative complications included suction of organs into outflow and incomplete circuit closure at outflow.
Closed perfusion with double outflow: Of 4 mice, 3 survived to 24-hour post-operative end-point. Incomplete circuit closure at outflow was the only prominent complication.
Open coliseum: Of 3 mice, 3 survived to 30-day post-operative end-point. This design presented excellent perfusate distribution, no organ suction, and allowed intraoperative organ manipulation.
Conclusion:
Survival mouse model closely mimicking HIPEC is achievable and can be customized to either open or closed perfusion techniques.
