Problems associated with the administration of intraperitoneal therapy using the Port-A-Cath system.

Ovarian and fallopian tube carcinomas tend to spread by surface implantation through the peritoneal cavity and remain principally confined to the intra-abdominal space for prolonged periods of time. Because of the spread pattern, patients with these diseases may be candidates for intraperitoneal (IP) therapy. The authors reviewed hospital records of 137 patients who had subcutaneous access ports and intraperitoneal catheters (Port-A-Cath) placed between August 1985 and July 1987 at Memorial Sloan-Kettering Cancer Center (MSKCC). Of these 137 patients, 106 received IP therapy at MSKCC and were evaluable for this retrospective study. The data extracted were: patient characteristics (age, histology, site, stage, prior therapy), total number of times ports were accessed, reasons for access, catheter function, catheter-related problems, and the total number of IP protocols involved during study time. The multiple uses of the IP catheter were: intraperitoneal chemotherapy or immunotherapy, drainage of ascites for patients' comfort and cytological analysis, a combination of drainage and IP treatments. Problems evaluated in association with use were: catheter function (ability to inject and/or drain), incidence and degree of pain during IP treatment, incidence and severity of infection, and medical and nursing procedures used to manage catheter dysfunction. A total of 16 catheters were removed for various reasons: infection (6); poor distribution of IP fluid (2); and catheter non-function (8). Of those, seven were replaced and IP treatment resumed. The overall rate of serious infection was 8.5% (9 infections in 8 patients). Major complications were infrequent and responded to medical or surgical treatment. This article describes our experience with the implanted system.