Fluoroscopically guided peritoneal catheter placement for intraperitoneal chemotherapy

Area of Science:

• Interventional Radiology
• Oncology
• Surgical Procedures

Background:

• Surgical placement of intraperitoneal catheters for chemotherapy carries risks such as bowel perforation and peritonitis.
• Temporary intraperitoneal catheters are crucial for delivering chemotherapy to patients with peritoneal carcinomatosis or sarcomatosis.

Purpose of the Study:

• To evaluate the safety and efficacy of fluoroscopically guided placement of temporary intraperitoneal catheters for chemotherapy delivery.

Main Methods:

• Fluoroscopically guided percutaneous placement of 8.3- or 8.5-F multiple-side-hole catheters using the Seldinger technique in 88 patients.
• Initial peritoneal puncture with 22-gauge needles and liberal use of contrast material.
• Computed tomographic (CT) peritoneography performed prior to chemotherapy to assess contrast distribution.

Main Results:

• Technical success rate of 94.5% (190/201) for catheter insertions.
• Significant complications occurred in 5.5% of procedures, including unintended bowel intubations and mild peritonitis.
• CT peritoneography revealed varying degrees of contrast distribution, with free distribution in 39% of cases.

Conclusions:

• Percutaneous catheter placement using small-gauge needles for initial puncture is a safe and effective method for short-term peritoneal access in chemotherapy.
• Fluoroscopic guidance facilitates accurate catheter placement and minimizes procedural risks.
• This technique offers a viable alternative to surgical placement for intraperitoneal chemotherapy.