Problems of peritoneal access in intraperitoneal treatment and monitoring of ovarian cancer.
A total of 154 peritoneal lavages was attempted through either a permanent (17) or a temporary percutaneous cannula (137) in 59 ovarian cancer patients undergoing intraperitoneal treatment or monitoring. Seven of the eight permanent catheters were removed because of complications; intraperitoneal adhesions were a major problem in this group. Overall, 137 temporary catheters were inserted (14G Venflon i.v. cannula in 119, Verres needle in 15, and a Trocath peritoneal dialysis catheter in 3 instances) but it was not possible to perform a peritoneal lavage in 42 (30%). Access to the peritoneal cavity was unsatisfactory on 29 (34%) occasions when a Venflon cannula was used, either because there was inadequate flow of lavage fluid into the peritoneal cavity or this was limited by pain. Perforation of the bowel occurred in 12 (9%) cases but there was no significant morbidity. Problems with achieving reliable peritoneal access using either permanent or temporary catheters may limit the potential advantages of the intraperitoneal route for treatment and monitoring.
Redman
C W
CW
Department of Obstetrics and Gynaecology, University of Birmingham.
Lawton
F G
FG
Luesley
D M
DM
Buxton
E J
EJ
Blackledge
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000628:therapy*; D010533:Peritoneal Lavage / Q000379:methods*