Zanon C, Grosso M, Clara R, Chiappino I, Mancini A, Mussa A
Service of Surgical Oncology, University of Turin, Molinette Hospital, Torino, Italy.
Anticancer Res. 1999 Nov-Dec;19(6C):5667-71.
Hepatic artery infusion is the best choice of treatment for colorectal liver metastases, but it could be suggested for other hepatic tumors or locally advanced pancreatic cancer. The need of a laparotomy for the positioning of the arterial catheter has been the limiting factor for the diffusion of regional treatments.
170 patients suffering from primary or secondary liver tumours and pancreatic or bile ducts cancer, underwent the positioning of intra-arterial hepatic part-a-cath by a transcutaneous subclavian access in local anaesthesia. In 163 patients, a catheter was placed into the hepatic artery, 4 into the splenic and 3 into the gastroduodenal artery.
The procedure was performed successfully in all patients. We observed 5 aneurysms of the subclavian artery and 9 thrombosis of the hepatic artery. Only in 7 patients was arterial infusion suspended for technical complications. We observed 10.6% of dislocation, but dislodged catheters were always moved again into the hepatic artery.
The development of percutaneous techniques of arterial port-a-cath implantation could enlarge the indication of regional chemotherapy.
肝动脉灌注是结直肠癌肝转移的最佳治疗选择，但也可用于其他肝脏肿瘤或局部晚期胰腺癌。动脉导管定位需要开腹手术一直是区域治疗推广的限制因素。
170例原发性或继发性肝脏肿瘤以及胰腺或胆管癌患者，在局部麻醉下通过经皮锁骨下途径进行肝动脉部分-a-导管的定位。163例患者的导管置入肝动脉，4例置入脾动脉，3例置入胃十二指肠动脉。
所有患者手术均成功完成。我们观察到5例锁骨下动脉动脉瘤和9例肝动脉血栓形成。仅7例患者因技术并发症暂停动脉灌注。我们观察到10.6%的导管移位，但移位的导管总是能再次移入肝动脉。
经皮动脉植入端口-a-导管技术的发展可扩大区域化疗的适应证。
