Journal of Surgery Concepts & Practice >
Complications of implanted subcutaneous port for intraperitoneal chemotherapy in gastric cancer patients with peritoneal metastasis and analysis of risk factors of complications
Received date: 2020-11-23
Online published: 2022-07-28
Objective To analyze the port complications and risk factors associated with the port complications in gastric cancer patients with peritoneal metastasis. Methods The medical records of 323 patients with subcutaneous ports implantation for intraperitoneal chemotherapy were retrospectively analyzed and 261 gastric cancer patients with peritoneal metastasis were included. Port complications and risk factors associated with complications were analyzed. Results There were 59 (22.6%) cases with port complications associated with intraperitoneal chemotherapy in all included 261 cases. Subcutaneous effusion (25 cases, 42.4%) and port infection (16 cases, 27.1%) were the main complications, followed by port rotation (9 cases, 15.3%), partial port wound dehiscence (7 cases, 11.9%), catheter obstruction (1 case, 1.7%) and subcutaneous metastasis (1 case, 1.7%). The median period between port implantation and occurrence of complications was 3.0 months. Eastern Cooperative Oncology Group (ECOG) score, serum albumin, implantation management optimization and implantation specialized group were independent risk factors for port complications (P<0.05). ECOG score was the only factor that related to the grade of port complications (P<0.05). Conclusions Port implantation would be safe and feasible for gastric cancer patients with peritoneal metastasis who received intraperitoneal chemotherapy. ECOG score, serum albumin, implantation ma-nagement optimization and specialized group are independent risk factors associated with port complications.
YANG Zhongyin, LI Chen, LIU Wentao, SHI Min, WU Junwei, ZHENG Yanan, ZHU Zhenglun, HUA Zichen, NI Zhentian, LU Sheng, YAN Min, YAN Chao, ZHU Zhenggang . Complications of implanted subcutaneous port for intraperitoneal chemotherapy in gastric cancer patients with peritoneal metastasis and analysis of risk factors of complications[J]. Journal of Surgery Concepts & Practice, 2021 , 26(01) : 41 -47 . DOI: 10.16139/j.1007-9610.2021.01.009
| [1] | National Health Commission of The People's Republic of China. Chinese guidelines for diagnosis and treatment of gastric cancer 2018 (English version)[J]. Chin J Cancer Res, 2019, 31(5):707-737. |
| [2] | Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019[J]. CA Cancer J Clin, 2019, 69(1):7-34. |
| [3] | Shinkai M, Imano M, Chiba Y, et al. Intraperitoneal and systemic chemotherapy for patients with gastric cancer with peritoneal metastasis: a phase Ⅱ trial[J]. Anticancer Res, 2018, 38(10):5975-5981. |
| [4] | Emoto S, Ishigami H, Hidemura A, et al. Complications and management of an implanted intraperitoneal access port system for intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis[J]. Jpn J Clin Oncol, 2012, 42(11):1013-1019. |
| [5] | Yang Z, Li C, Liu W, et al. Complications and risk factors for complications of implanted subcutaneous ports for intraperitoneal chemotherapy in gastric cancer with peritoneal metastasis[J]. Chin J Cancer Res, 2020, 32(4):497-507. |
| [6] | 薛侃, 李子禹, 闫国军, 等. 腹腔化疗港在胃癌腹膜转移中应用的安全性分析[J]. 中国肿瘤临床, 2019, 46(1):34-38. |
| [7] | 严超, 石红鹏, 刘瑩, 等. 胃癌腹膜转移的新辅助腹腔内联合全身化疗:初步研究[J]. 外科理论与实践, 2017, 22(1):32-39. |
| [8] | Bonnot PE, Piessen G, Kepenekian V, et al. Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastases(CYTO-CHIP study): a propensity score analysis[J]. J Clin Oncol, 2019, 37(23):2028-2040. |
| [9] | Ishigami H, Fujiwara Y, Fukushima R, et al. Phase Ⅲ trial comparing intraperitoneal and intravenous paclitaxel plus S-1 versus cisplatin plus S-1 in patients with gastric cancer with peritoneal metastasis: PHOENIX-GC trial[J]. J Clin Oncol, 2018, 36(19):1922-1929. |
| [10] | Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey[J]. Ann Surg, 2004, 240(2):205-213. |
| [11] | Owens CD, Stoessel K. Surgical site infections: epidemio-logy, microbiology and prevention[J]. J Hosp Infect, 2008, 70(Suppl 2):3-10. |
| [12] | Davidson SA, Rubin SC, Markman M, et al. Intraperitoneal chemotherapy: analysis of complications with an implanted subcutaneous port and catheter system[J]. Gynecol Oncol, 1991, 41(2):101-106. |
| [13] | Makhija S, Leitao M, Sabbatini P, et al. Complications associated with intraperitoneal chemotherapy catheters[J]. Gynecol Oncol, 2001, 81(1):77-81. |
| [14] | Malmstrom H, Carstensen J, Simonsen E. Experience with implanted subcutaneous ports for intraperitoneal chemotherapy in ovarian cancer[J]. Gynecol Oncol, 1994, 54(1):27-34. |
| [15] | Gong Y, Wang P, Zhu Z, et al. Benefits of surgery after neoadjuvant intraperitoneal and systemic chemotherapy for gastric cancer patients with peritoneal metastasis: a meta-analysis[J]. J Surg Res, 2020, 245:234-243. |
| [16] | Ishigami H, Yamaguchi H, Yamashita H, et al. Surgery after intraperitoneal and systemic chemotherapy for gastric cancer with peritoneal metastasis or positive peritoneal cytology findings[J]. Gastric Cancer, 2017, 20(Suppl 1):128-134. |
| [17] | Sok M, Zavrl M, Greif B, et al. Objective assessment of WHO/ECOG performance status[J]. Support Care Cancer, 2019, 27(10):3793-3798. |
/
| 〈 |
|
〉 |