[Evaluation of surgical complications connected with intraperitoneal chemotherapy in ovarian cancer]

From a theoretical viewpoint, the use of intraperitoneal therapy (i.p.) in patients with ovarian cancer (a malignancy, which remains mainly confined to the peritoneal cavity) is logical. Intraperitoneal catheters have moved to the forefront as a delivery system in cancer treatment. Authors described complications during the placement, usage, and evacuation of Tenckhoff catheters. Some of them report much too high number of surgery complications connected with i.p.

We report a number of complications connected with insertions, functions, and evacuations of Tenckhoffa catheter.

From January 1996 to January 2002, 92 patients with recurrent or persistent ovarian cancer, after surgery and first line chemotherapy, have had catheter insertion performed, but only 79 have had performed catheter evacuation: because of: not complete therapy (7 patients), three patients died during i.p. therapy, in three cases intraperitoneal catheter has spontaneously fold out.

During insertion total number of complications 9(9.78%), 6 bowel incision, 1 bladder incision, 1 hernia of the linea alba, 1 incision of bowel and bladder. During catheter evacuation total number of complications 9 (11.39%), 8 bowel incisions 1 hernia of the linea alba. Complications connected with catheter function: only 8 of 92 (8.70%) required cessation of chemotherapy prior to its expected completion, 2 fistula of the catheter to vagina, 2 fistulas to bowel, in two cases intraperitoneal catheter has spontaneously fold out due to abscess, one after citostatics flow under the skin, one because of abscess in peritoneal cavity, and problems with citostatics inflow one because of subileus.

The surgical complications occurring during IPC are not dangerous for patients. IPC is valid and safe way of treatment patients with ovarian cancer. The frequency of complications occurring during insertion of Tenckhoff catheter depends on the way of placement.