Catheter complications associated with intraperitoneal chemotherapy

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.