A case of protrusion of an intraperitoneal chemotherapy catheter through rectum

Bilsel, Y.; Balik, E.; Bugra, D.; Yamaner, S.; Akyuz, A.

doi:10.1136/ijgc-00009577-200501000-00026

Cited by 4 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, there were no complications related to bowel, though reported to occur at a rate of 3-5 % and include fistulas, catheter migration in to the bowel lumen, bowel obstruction and perforations [7][8][9][10][11][12]. In our study, none of the venous catheters had obstruction but in the initial 20 fenestrated catheters five had obstruction, indicating that venous catheters are less prone for obstruction.…”

Section: Discussionmentioning

confidence: 48%

See 1 more Smart Citation

Intraperitoneal Chemotherapy for Epithelial Ovarian Cancer – Single Center Experience

Jaka

Somashekhar

Zaveri

et al. 2012

Indian J Surg Oncol

View full text Add to dashboard Cite

Majority of intraperitoneal (IP) chemotherapy complications were related to the chemoport. Aim of our study was to find the means of reducing complications of IP chemoport, to increase the benefits of IP chemotherapy. During January 2007 to December 2010, hundred consecutive patients of stage III epithelial ovarian cancer who had optimal cytoreduction underwent chemoport insertion during laparotomy. Initial 20 cases had 14.3F Bard IP chemoport, and later cases had 9.6Fr single lumen venous port inserted intraperitoneally. Entry point into the peritoneum was single, 6 cm lateral to the umbilicus and double purse-string suture taken around the catheter to prevent peri-catheter backflow of ascitic fluid or drug. Modified IP chemotherapy regimen (SWOG-9912 trial) was used. Age of the patient ranged from 34 years to 76 years. In total 600 cycles, 516 cycles (86 %) were completed. Seventy patients (70 %) received all the 6 cycles by IP route. Two in the initial 10 patients had vaginal leak, for whom first 2 cycles were given by IV route and then shifted to IP route. Subsequently all cases had double layer closure of vaginal vault. Nine patients (9 %) had port related complications, in which 8 were transient. Catheter block was seen in 5 cases, of which 4 salvaged by heparin injection lock for 2 h and in subsequent cases IV port access catheter with valve replaced the fenestrated IP catheter. None of the IV catheters had the block. Four cases had backflow of fluid around catheter collecting around the port chamber site. Two patients had severe abdominal pain due to dense adhesions and further cycles were completed by IV route. Cisplatin was replaced with carboplatin in 5 cases with severe toxicity. Longest follow-up is 4 years with median follow up of 1.8 years.70 % are disease free on follow up. Local recurrence rate was 18 and systemic in 8 cases. Mortality rate is 4 %. Complications of IP ports are low when insertion is done meticulously with a dedicated team. With modified IP dose and drug regimen, side effects are less and most patients can complete all the desired cycles.

show abstract

Section: Discussionmentioning

confidence: 48%

“…Potential benefits of adhesion barriers have not been validated in a randomized trial. IP catheters should be removed after completion of current therapy, as complication rates are high, on retaining for longer period [11]. It is removed under local anesthesia on outpatient basis.…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal Chemotherapy for Epithelial Ovarian Cancer – Single Center Experience

Jaka

Somashekhar

Zaveri

et al. 2012

Indian J Surg Oncol

View full text Add to dashboard Cite

show abstract

“…The meta-analysis cannot draw conclusions on hematologic, renal, neurologic, and lung toxicity, as the data are too heterogeneous and will largely depend on the regimen used. The results of this meta-analysis should be used as part of this decision-making process, taking into consideration the potential for catheter-related complications that include blockade, leakage, infection, bowel perforation, and fistula formation (70,(74)(75)(76)(77) . The optimal dose, timing, and mechanism of administration of IP chemotherapy cannot be addressed from this metaanalysis (73) .…”

Section: Ip Chemotherapy As First-line Treatment In Patients With Minmentioning

confidence: 99%

Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature

Gadducci

Conte

2008

Int J Gynecol Cancer

View full text Add to dashboard Cite

The use of intraperitoneal (IP) chemotherapy has been advocated in different settings of patients with ovarian cancer. Cisplatin is the drug of choice because of its high response rate and minimal local toxicity. This treatment can be given to women with small residual disease after second look, with surgically assessed complete response rates of approximately 30%, and with a prolonged survival in small subset of patients. However, the use of IP chemotherapy as consolidation treatment of pathologically complete responders after first-line systemic chemotherapy has not been definitively evaluated in a phase III trial. There is much debate in the literature both for and against the use of IP chemotherapy in the first-line treatment of optimally debulked ovarian cancer patients. The recent Cochrane meta-analyses of eight randomized trials enrolling 1819 patients has shown that first-line IP chemotherapy improves progression-free survival and overall survival of patients with minimal residual disease after initial surgery. However, the potential for catheter-related complications, abdominal pain with infusion, and toxicities needs to be taken into consideration for decision making in each individual woman. Rectosigmoidal surgery can be associated with gross contamination of the operative field, and in this case, the catheter placement should not be performed during primary surgery but should be delayed to 3 weeks later. Patients should be provided with information on the survival and toxicity for both IP and systemic treatments, as well as practical information about the administration of each regimen, so that they may be involved in the decision-making process.

show abstract

“…In addition, if the catheter is fixed to the midline, it might get blocked by remnants of omental fat. Complications have been reported when the catheters are retained (21,22) . It is advisable to remove the catheter once treatment is completed.…”

Section: Catheter Optionsmentioning

confidence: 99%

Intraperitoneal chemotherapy for advanced epithelial ovarian cancer: a Canadian perspective

Alhayki,

Hopkins,

et al. 2006

Int J Gynecol Cancer

View full text Add to dashboard Cite

The objectives of this study were to: a) assess the position of Canadian gynecological oncologists (GOC) toward intraperitoneal (IP) chemotherapy as primary treatment for ovarian cancer, b) initiate a process of communication among GOC, and c) assess the perception of barriers to implementing IP chemotherapy across Canada. An electronic practice survey was mailed to all GOC in January 2006. The response rate was 62%. GOC accept IP chemotherapy as the standard of care in the primary treatment of optimally debulked epithelial ovarian cancer. The majority of respondents were working on implementation strategies at their local institutions. The cost of administration and use of additional resources were identified as sources of moderate and high concerns, respectively. Moderate concerns were expressed with regard to the management of systemic and local toxicity, catheter complications, patients' acceptance, and quality of life. Catheter insertion issues were of low concern to most respondents. Previous experience with IP administration did not significantly impact the perceived level of concern. GOC support the use of IP chemotherapy for appropriate patients with ovarian cancer. This survey identifies important implementation challenges of IP therapy for Canada, and processes must be developed before successful delivery of IP chemotherapy can be realized. This survey serves to initiate a process of communication among GOC. A collaborative effort will be needed to facilitate this change in practice. Further study of the implementation process is warranted as more experience is gained with this modality of treatment.

show abstract

A case of protrusion of an intraperitoneal chemotherapy catheter through rectum

Cited by 4 publications

References 6 publications

Intraperitoneal Chemotherapy for Epithelial Ovarian Cancer – Single Center Experience

Intraperitoneal Chemotherapy for Epithelial Ovarian Cancer – Single Center Experience

Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature

Intraperitoneal chemotherapy for advanced epithelial ovarian cancer: a Canadian perspective

Contact Info

Product

Resources

About