Clinical Study Of Percutaneous Implantation Of Port-catheter System In The Right Lower Abdomen For Arterial Infusion Therapy Of Unresectable Liver Malignant Tumors

Objective: To investigate the advantage,disadvantage, practicability and validity of percutaneous transfemoral arterial implantation of port-catheter system in the right lower abdomen for arterial infusion therapy of unresectable liver advanced malignant tumors. Materials and Methods: From September 1995 to October 2002, 79 patients with unresectable liver advanced malignant neoplasm were enrolled in this study. All were treated with intra-arterial infusion therapy via port-catheter system in the right lower abdomen by percutaneous transfemoral artery, 60 males and 19 females, aged 26~79 years, average (51.06±13.12)years, including primary hepatic cancer(n=:32), metastatic cancer(n=47). The operations need puncture on the higher location of in the front of the right femoral artery, the catheter turning 45°~90° at the puncture point. 79 patients were treated with intraarterial chemotherapy and/or chemoembolization with anticancer drugs and lipiodol emulsion via PCS every monthly. The first day, injection of CDDP40- 60mg, E-ADM 20~40mg, then, inject 5-Fu 1~2g, CF 100mg/m2, dexamethasone 10mg at speed of 2 or 5ml/h by easypump , and were flushed with heparin saline salution once every two weeks. Results: The rate of success was 100%. The tip of catheters was lay in the common hepatic artery(18 cases), in the hepatic artery proper(39 cases) , in the right and left hepatic artery branch(18 cases, 2cases), in thegastroduodenal artery(2 cases). If the tip of catheters was lay in the common hepatic artery and the hepatic artery proper, the gastroduodenal artery was embolized by embolization coil stainless steel besides Teases. The rate of complications related to the technique is 8.86%, included: port was rolled (1 case), wound closure was delayed (2 cases), occlusion of PCS catheter (1 case), dislodgement of indwelling catheter tip (3 cases) .The PCS was used 5 times averagely with a range of 2 to 12 times, the average cost is RMBY2712. the 3 months~,0.5~,1~, and 2~year survival rate were 95%(75/79), 73.4%(58/79),46.8%(37/79) and 20.2%( 16/79), The tumors disappearance and shrinkage more than 50% in diameter were detected in 6.3%(5/79) by CT in 1-6 months following-up, and that less than 50% also 57%(45/79), No change and enlargement of rumors were present in 36.7%(29/79).Conclusion: The implanting of PCS in the right lower abdomen was simple with high success, less traumatic and little complication, the movements-flexion of the right hip joint do not affect the catheter. It provides a convenient, comfortable and high secure route of intra-arterial chemotherapy for patients with unresectable liver malignant tumors.