LAPAROTOMY VERSUS INTERVENTIONAL RADIOLOGICAL PROCEDURES FOR THE IMPLANTATION OF ARTERIAL INFUSION DEVICES

Although there have been numerous reports on implantable infusion devi ces for chemotherapy of patients with malignancy, we occasionally face problems with this therapy due to trouble with implantation, We perfo rmed a retrospective review of 81 implantations in 77 patients, who we re treated with intraarterial chemotherapy via implanted devices from 1985 to 1993. They were divided into two groups according to the proce dures: the operative procedure group (group A, n = 41) and the interve ntional radiological procedure group (group B, n = 34), Both groups we re then analyzed regarding the respective complications. We experience d 25 complications: (a) 9 obstructions of the catheter, (b) 4 infectio ns, (c) 4 dislocations of the catheter, (d) 3 hematomas, (e) 3 breakdo wns of the device, (f) 1 pneumothorax, and (g) 1 hepatic artery occlus ion, The results of a comparison of the complication rate between grou ps A and B were (a) 14.0%:8%, (6) 4%:0%, (c) 0%:10%, (d) 4%:2%, (e) 7% :0%, (f) 0%:2%, and (g) 2%:0%, respectively. A statistically significa nt difference n as observed for (b) and (c) (P < 0.05). Infection occu rred mainly in the cirrhotic cases of group A, but not in group B. In addition, one case fell into fatal sepsis, Based on the above findings , the interventional radiological procedure is thus considered to be W e appropriate method for the prevention of infection in the case of a compromised host.