Catheter complications associated with intraperitoneal
chemotherapy were evaluated in 171 patients (pts) with primary intra-abdominal
malignancies. In 96 pts and 488 courses, single-use
catheters (SUC) (3/G 14 Braun) were used between years 1990-1993. In 75 pts and 283 courses a semi-permanent subcutaneous implantable port and
catheter system (
SIPC) (T 2035/460 mm-F 14-76 Braun) was used between years 1993-1996.
Cisplatin (60-75 mg/sqm),
5-fluorouracil (600 mg/sqm),
calcium folinate (150 mg),
etoposide (180 mg/sqm),
mitoxantrone (12-15 mg/sqm) were given in various combinations and periods to patients with ovarian
carcinoma (106 pts), gastrointestinal
carcinoma (43 pts),
hepatocellular carcinoma (17 pts) and
mesothelioma (5 pts). The incidence of patients with complications was significantly higher in SUC (45%) than
SIPC (23%) (p=0.001). Colon
puncture (8.8%, p<0.0001) and subcutaneous leakage (3.7%, p<0.01) rate of the courses were significantly higher in SUC.
Pain related to
catheter complications (6%, p<0,0002), local
infection (1.4%, p=0.02) and obstruction (1.4%, p=0.02) were significantly higher in
SIPC. The most important local complications were intra-abdominal
fibrosis and adhesions that were surgically documented in 90% of the
ovarian cancer patients, and were more severe in patients with the
SIPC system. The complication rate and the complication type of these two
catheters were found to be significantly different in this retrospective analysis; in order to determine the real complication rate, safety, efficacy and overall acceptability of the
catheters, a randomised trial is needed.