[Pressurized intraperitoneal aerosol chemotherapy (PIPAC): techniques, operational specifications and occupational...

Peritoneal metastasis is a common pattern of metastasis for gastrointestinal and ovarian malignancies and is associated with an extremely poor prognosis. Recently, Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC), a novel locoregional drug delivery technology, has garnered significant attention. It delivers low-dose aerosolized chemotherapeutic drugs into the abdominal cavity, utilizing capnoperitoneum pressure and aerosol properties to achieve a more homogeneous spatial distribution and superior tissue penetration. Currently, numerous international studies have demonstrated the favorable safety, tolerability, and efficacy of PIPAC, leading to established expert consensus on its indications, technical procedures, and safety measures. However, a systematic and standardized PIPAC operational protocol remains lacking in China, owing to limited equipment accessibility and insufficient clinical evidence. Based on current research progress and international consensus, combined with characteristics of the domestic PIPAC system equipped with a high-pressure peristaltic pump and preliminary domestic clinical experiences, this paper formulates technical specifications and occupational protection recommendations for PIPAC in China. It systematically elaborates on patient selection, perioperative preparation, standardized operational procedures, and safety measures. This study aims to provide actionable and replicable technical guidance, ensuring treatment safety and operational reproducibility, thereby facilitating the standardized application and clinical promotion of PIPAC in China.