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胃癌合并腹膜转移行腹腔内化疗植入式腹腔内置管系统的并发症及处理。

Complications and management of an implanted intraperitoneal access port system for intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis.

机构信息

Department of Surgical Oncology, The University of Tokyo, and Department of Outpatient Chemotherapy, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

出版信息

Jpn J Clin Oncol. 2012 Nov;42(11):1013-9. doi: 10.1093/jjco/hys129. Epub 2012 Aug 7.

Abstract

OBJECTIVE

The efficacy of intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis has been verified by clinical trials. To perform intraperitoneal chemotherapy safely and effectively, the appropriate management of intraperitoneal access ports is essential. The aim of this study was to investigate the occurrence of port complications during cyclically repeated intraperitoneal chemotherapy.

METHODS

The medical records of 131 gastric cancer patients with peritoneal metastases who received intraperitoneal paclitaxel between 2005 and 2011 were retrospectively analyzed.

RESULTS

The median period of intraperitoneal chemotherapy using a port system was 12.9 months (range: 0.8-61.5 months), and a total of 27 (20.6%) patients experienced port complications. Inflow obstruction (7.6%) and infection (6.9%) were the main complications, followed by reflux (3.1%), subcutaneous masses (1.5%) and fistulae (1.5%). The median interval between port implantation and port complication was 5.4 months (range: 0.3-40.9 months). Complications were controllable and chemotherapy was not terminated by complications. Survival was not affected by the presence or absence of port complications (median survival time: 22.5 vs. 17.2 months, respectively; P=0.65).

CONCLUSIONS

Intraperitoneal chemotherapy for gastric cancer using a port is safe and feasible under appropriate management.

摘要

目的

临床试验已经证实了腹腔内化疗治疗胃癌伴腹膜转移的疗效。为了安全有效地进行腹腔内化疗,对腹腔内接入端口进行适当的管理是至关重要的。本研究旨在探讨在周期性重复腹腔内化疗过程中端口并发症的发生情况。

方法

回顾性分析了 2005 年至 2011 年间接受腹腔内紫杉醇治疗的 131 例胃癌伴腹膜转移患者的病历。

结果

使用端口系统进行腹腔内化疗的中位时间为 12.9 个月(范围:0.8-61.5 个月),共有 27 例(20.6%)患者发生了端口并发症。主要并发症为流入道阻塞(7.6%)和感染(6.9%),其次是反流(3.1%)、皮下肿块(1.5%)和瘘管(1.5%)。端口植入与端口并发症之间的中位间隔时间为 5.4 个月(范围:0.3-40.9 个月)。并发症是可控的,且不会因并发症而终止化疗。生存时间不受端口并发症的存在与否的影响(中位生存时间:分别为 22.5 个月和 17.2 个月;P=0.65)。

结论

在适当的管理下,使用端口进行胃癌腹腔内化疗是安全可行的。

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