Technical considerations in the use of intraperitoneal chemotherapy administered by Tenckhoff catheter

Technical aspects of the clinical management of 69 patients who had a Tenckhoff catheter implanted for chemotherapy infusion were reviewed. Catheter placement under local anesthesia was performed using a trochar. Three patients had intestinal perforation. Also, bacterial peritonitis occurred in three patients, an incidence of 10 per cent per catheter year. Peritonitis responded to antibiotic treatment without catheter removal. If the catheter failed to infuse or drain, irrigation and instrumentation were used to reopen the catheter. An absolute indication for catheter removal was infection of the Dacron cuff. Intraperitoneal chemotherapy was thought to be a safe way in which to deliver high concentrations and large amounts of drug to the abdominal cavity. In selected tumors, there may be a significant pharmacologic advantage over conventional routes of administration. Proper catheter insertion and maintenance were required to keep complications of this treatment modality to a minimum.