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SURGICAL COMPLICATIONS CONNECTED WITH INTRAPERITONEAL HEMOTHERAPY IN OVARIAN CANCER

OBJECTIVES
From a theoretical viewpoint, intraperitoneal therapy (i.p.) in-patients with ovarian cancer, a malignancy, which remains mainly, confined to the peritoneal cavity is logical. Intraperitoneal catheters have moved to the forefront as a delivery system in cancer treatment. Authors have described complications during the placement, usage, and evacuation of Tenckhoff catheters.


MATERIAL AND METHODS
From January 1996 to January 2003, 118 patients with recurrent or persistent ovarian cancer, after surgery and first line chemotherapy, have had catheter insertion, but only 91 have had catheter evacuation: because of: not complete therapy (21 patients). Three patients died during i.p. therapy, Four times intraperitoneal catheter has spontaneously fold out.


RESULTS
During insertion total number of complications reached (7.63%)--6 bowel incision, 1 bladder incision, 1 hernia of the linea alba, 1 incision of bowel and bladder. During catheter evacuation total number of complications was 9 (7.63%), 8 bowel incisions, 1 hernia of the linea alba. Complications connected with catheter function: only 10 patients required cessation of chemotherapy prior to its expected completion because of following reasons: 2 fistula of the catheter to vagina, 2 fistulas to bowel, in four cases intraperitoneal catheter has spontaneously fold out due to abscess (two after citostatics flow under the skin, and two without clear reason probably because of not proper fixation) one because of abscess in peritoneal cavity, and problems with citostatics inflow, one because of subileus.


CONCLUSION
1 Surgical complications occurring during IPC are not dangerous for patients. 2 IPC is valid and safety way of treatment ovarian cancer patients. 3 The frequency of complications occurring during insertion of Tenckhoff catheter depends on the way of placement. 4 We do not noticed connections between frequency of complications and sum of insertion made by the surgeon.