Major device-related complications during regional chemotherapy

Abstract From September 1985 to December 1990, 51 patients were treated by locoregional chemotherapy by means of a totally implantable system: 35 patients for hepatic metastases from colorectal cancer and 2 for hepatocellular carcinoma had the system implanted in the hepatic artery via the gastroduodenal artery; 14 patients underwent peritoneal chemotherapy, 11 for peritoneal carcinomatosis and 3 for adjuvant therapy. Totally implantable arterial 'ports' were used for the hepatic chemotherapy, while Tenckhoff-type ports were used for peritoneal chemotherapy. Among the 51 cases, 6 major complications were observed, 5 in the group submitted to hepatic chemotherapy and one following intracavitary therapy. The complications observed were thrombosis of the hepatic artery in 2 cases, dislodgement of the catheter into the duodenal lumen in 2 cases, and 1 case of rupture of the catheter. The complications were treated by suspension of the therapy for hepatic artery thrombosis, endoscopic removal of the catheter from the duodenum (dislodgement) and explant of the system (rupture of the catheter). In 1 case we observed the dislodgement of the Tenckhoff port into the intestinal lumen and in this case laparotomy was necessary for catheter removal.