SCINTIGRAPHIC METHOD TO TEST THE FUNCTION OF INTRAPERITONEAL DRAININGCATHETERS FOR REGIONAL INTRAABDOMINAL CHEMOTHERAPY

Aim: Intraoperative peritoneal chemohyperthermia (IPCH) followed by on e or more courses of closed intraperitoneal chemotherapy via peritonea ldialysis-catheter (Zellermann) is a promising concept for treatment o f peritoneal carcinomatosis. Methods: To prove the functionality of th e catheter a scintigraphic method is introduced using a liquid solutio n of sodium chloride - Tc-99m-Diethylenetriaminepentaacetic acid (Tc-9 9m-DTPA) (500 mi). This study was aimed to look for problems over the period of application and to measure the intraperitoneal distribution and resorption of the fluid. Results: One leakage and 3 revisible obst ructions occured in 26 applications done in 20 patients. The upper rig ht and the central abdomen was not reached as extensive as the other r egions. The abdomen was divided into 9 regions of equal size. in 4 out of 19 patients (20%) the fluid tracer was missed in more than 3 regio ns (up to 40% of the total area). Conclusions: It is to early to decid e whether mythological modifications are necessary in these cases, but closed chemotherapies in patients with maldistribution may not be ind icated. This will be in particular necessary if there is a relation be tween the maldistribution and the location of recurrencies. The demons trated simple scintigraphic method, however, is able to recognize pati ents at risk.