Complications associated with Ommaya reservoirs in patients with cancer. The Princess Margaret Hospital experience and a review of the literature.
The complications associated with the use of Ommaya reservoirs in 106 patients with meningeal involvement due to malignant disease are reviewed. Twenty-seven patients had acute lymphoblastic leukemia, 12 acute myelogenous leukemia, 3 chronic lymphocytic leukemia, 34 lymphoma, 29 carcinoma, and 1 chronic myelocytic leukemia. There were 11 technical complications, including 1 death due to misplacement of the catheter, 2 mild intraventricular hemorrhages, and 5 malfunctioning reservoirs; 3 required craniotomies (1 for subdural hematoma and 2 for subdural hygroma); 13 cases of bacterial meningitis occurred in 10 patients. One patient died of Staphylococcus aureus meningitis. The organisms causing the other infections were mainly coagulase-negative staphylococci (8 cases) or Propionibacterium acnes (2 cases). The projected infection rate for all patients (by Kaplan-Meier analysis) during the first year following insertion of a reservoir was 15%. Successful use of Ommaya reservoirs requires expert surgical implantation and meticulous care during accessing to minimize complications.
Department of Medicine, Ontario Cancer Institute, Toronto, Canada.
M
M
Lishner
R G
RG
Perrin
R
R
Feld
H A
HA
Messner
P G
PG
Tuffnell
T
T
Elhakim
A
A
Matlow
J E
JE
Curtis
D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000209:etiology*; D002552:Cerebral Ventricles; D005260:Female; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D008577:Meningeal Neoplasms / Q000628:therapy*; D008581:Meningitis / Q000209:etiology*; D008875:Middle Aged