Laparoscopic intra-arterial catheter implantation for regional chemotherapy of liver metastasis

Abstract

In patients with unresectable metastatic disease confined to the liver, intra-arterial regional chemotherapy with implantable systems in an attractive option. Since April 1992, laparoscopic colorectal resections have been performed in our institution. Within this series of patients, three cases with bilateral liver metastasis from colon cancer were observed and underwent laparoscopic intra-arterial catheter implantation in the gastroduodenal artery for regional chemotherapy. In two patients the metastases were synchronous, and in both cases a laparoscopic colon resection was also performed, for tumors located in the cecum and in the sigmoid colon, respectively. The laparoscopic surgical technique for intra-arterial catheter implantation is described in detail. In this limited experience the procedure, from a purely technical point of view, was not considered difficult and was completed in 70 min on average. No complications were observed and the patient with metachronous liver metastasis was discharged on 3rd postoperative day.

Laparoscopic Cryoablation of Hepatic Metastases

“…[39][40][41][42] Hepatic artery infusion catheters can be placed laparoscopically to deliver chemotherapeutic agents. 43 Resolving these issues and continued technical advancement are the current challenges in laparoscopic cryoablation of hepatic tumors.…”

Laparoscopic radiofrequency ablation and hepatic artery infusion pump placement in the evolving treatment of colorectal hepatic metastases

“…The fact RFA and HAIP placement can be performed laparoscopically [12,25,28] may afford a novel minimally invasive method of providing treatment in colorectal hepatic metastases. This review was undertaken to investigate the selection criteria, safety, efficacy, and early outcomes of patients treated laparoscopically with RFA and/or HAIP.…”

Laparoscopic Placement of Hepatic Artery Infusion Pumps: Technical Considerations and Early Results

“…Since then, there have been limited reports regarding this novel procedure, which include our own results. [10][11][12]19 The success of HAI therapy is dependent on careful patient selection and meticulous surgical technique. It is critically important that the distribution of chemotherapy reaches the entire liver without misperfusion.…”