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We aimed to evaluate the feasibility and tolerability of hyperthermic intraperitoneal carboplatin (HIPEC-carboplatin) following secondary cytoreduction for recurrent, platinum-sensitive ovarian cancer.In a single institution prospective, pilot study, ten patients underwent secondary cytoreductive surgery followed by HIPEC-carboplatin at 1000 mg/m(2). Consolidation (6 cycles) was with platinum-based regimens. Adverse and quality of life were measured throughout treatment.Twelve patients were enrolled of which 2 were excluded (one each for extra-abdominal disease indentified before surgery and suboptimal cytoreduction). All 10 remaining patients received prescribed HIPEC-carboplatin. There were no intra-operative complications or AEs attributable to HIPEC-therapy. Grade 1/2 nausea was the most common post-operative toxicity (6/10 patients). Two patients had grade 4 post-operative neutropenia and thrombocytopenia but only one experienced transient treatment delay. The median hospital stay was 5.5 days. 69/70 (98%) of planned chemotherapy doses were ultimately delivered with 1 patient electively forgoing her final treatment. At a median (range) follow-up of 16 (6-23) months, three patients have recurred at 8, 14, and 16 months from surgery. The median disease-free and overall survivals have not been reached. Fact-O scores were significantly lower following surgery (126 vs. 108, p.01), but improved by completion of therapy (108 vs. 113, p=0.27).HIPEC-carboplatin at 1000 mg/m(2) following optimal cytoreduction for ovarian cancer is feasible. Surgical complications were not observed, and post-operative AEs were largely within expected ranges. Consolidation using standard platinum-based regimens was feasible following HIPEC-carboplatin, and preliminary survival data suggests efficacy. Further investigation of HIPEC-carboplatin in the setting of debulkable cancer recurrence is warranted.

Objective This study was undertaken to evaluate the integrity of the loop-to-strand knot when tied with square and nonidentical sliding knots. Study design The synthetic absorbable monofilament suture poliglecaprone 25 in 0 and 2-0 suture gauges was used in this experiment. For each suture gauge, 3 groups of knots were tested: (1) single strand-to-single strand, flat square knot, (2) loop-to-single strand, flat square knot, and (3) loop-to-single strand, nonidentical sliding knot. All knots were tied with 6 throws. The proportion of knots becoming untied was compared among the 3 groups for each suture gauge. Ultimate load required to untie or break knots within each group was also evaluated. Results The loop-to-strand knot performed well in both suture gauges tested as long as it was tied with a flat square knot. The loop-to-strand knot tied with a nonidentical sliding knot had an unacceptably high failure rate. Conclusion The loop-to-strand termination of a continuous suture may be acceptable when tied with a 6-throw flat square knot but not acceptable if tied with sliding knots.

Objective The study was performed to test the knot integrity of parallel and nonidentical sliding knots with the use of monofilament suture. Study design We investigated the proportion of parallel sliding knots that become untied compared with nonidentical sliding knots in four different monofilament suture configurations: group A, 6 throws, 0-0 gauge; group B, 10 throws, 0-0 gauge; group C, 6 throws, 2-0 gauge; group D, 10 throws, 2-0 gauge. Each combination was tested 20 times, for a total of 160 knots. Results The nonidentical sliding knot untied 40% of the time in group A compared with 0% for the parallel knot (P = .003). In the other 6-throw group, group C, 45% of the nonidentical knots became untied compared with 0% of the parallel knots (P = .001). There were no significant differences in the proportions of untying for each knot type in the 10-throw groups. Conclusion Parallel sliding knots demonstrate superior knot integrity compared with nonidentical sliding knots with monofilament suture. The addition of throws to the nonidentical knot improves its knot security.