[Reasonable approach for prophylactic hepatic arterial infusion chemotherapy after potentially curative surgery for colorectal liver metastases].
The authors discuss the reasonable management of implantable ports and catheters after cessation of adjuvant hepatic arterial infusion (HAI) chemotherapy following curative resection of colorectal liver metastases. Local recurrence in the residual liver was observed in only 4 patients of thirty-two patients (13%). Although heparin administration into the port was regularly performed in 17 patients to prevent its occlusion, the ports were successfully maintained in only 9 patients at a median time of 11.8 months postoperatively, and only one patient received further regional chemotherapy for recurrent disease. These findings indicate that heparin administration to maintain the port brings little benefit. In the most recent 3 cases, we used a new Piolax W Spiral catheter and removed the catheter and port after cessation of adjuvant chemotherapy. No complication related to the procedure occurred, and patients' quality of life was well preserved, suggesting that this approach for HAI is reasonable and beneficial.
Tono
Takeshi
T
Dept. of Surgery, NTT West Osaka Hospital.
Kanoh
Toshiyuki
T
Nakano
Yoshiaki
Y
Okada
Kazuyuki
K
Murakami
Masahiro
M
Asaoka
Tadafumi
T
Takemoto
Hirotoshi
H
Imazato
Mitsunobu
M
Matsui
Shigeo
S
Iwazawa
Takashi
T
Yano
Hiroshi
H
Kinuta
Masakatsu
M
Okamura
Jun
J
Monden
Takushi
T
D002404:Catheterization; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000378:metabolism* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*