Percutaneous placement of peritoneal port-catheter in oncologic patients

Orsi, Franco; Vigna, Paolo Della; Penco, Silvia; Bonomo, Guido; Lovati, E.; Bellomi, Massimo

doi:10.1007/s00330-004-2367-4

Cited by 11 publications

(3 citation statements)

References 11 publications

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“…Both interventional nephrologists and radiologists have described percutaneous placement of peritoneal dialysis catheters by fluoroscopy (7,14). Additionally, the use of ultrasound needle insertion guidance to place port‐catheters in the peritoneal cavity for oncology patients has also been previously highlighted (15). Based on this information, we employed ultrasound to guide the entry into the abdominal cavity.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound/Fluoroscopy‐Assisted Placement of Peritoneal Dialysis Catheters

Maya

2007

Seminars in Dialysis

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Peritoneal dialysis (PD) catheters may be inserted blindly, surgically, and either by laparoscopic, peritoneoscopic, or fluoroscopic approach. A modified fluoroscopic technique by adding ultrasound-assistance was performed in the present study to ensure entry into the abdominal cavity under direct ultrasound visualization. From March 2005 to May 2007, ultrasound-fluoroscopic guided placement of PD catheters was attempted in 32 end-stage renal disease (ESRD) patients. Preoperative evaluation was performed on all patients prior to the procedure. After initial dissection of the subcutaneous tissue anterior to the anterior rectus sheath, the needle was inserted into the abdominal cavity under the guidance of ultrasound. The position of the epigastric artery was also examined using ultrasonography to avoid the risk of arterial injury. PD catheters were successfully placed in 31 of the 32 ESRD patients using this technique. In all of these patients, the needle could be seen entering the abdominal cavity using an ultrasound. In one patient the procedure was abandoned because of bowel puncture by the micro-puncture needle that was inadvertently advanced into a loop of bowel. This patient did not develop acute abdomen nor needed any intervention. One patient died 4 days after placement of the catheter of unrelated causes. One patient was started on acute peritoneal dialysis the same day of catheter placement without any complications. The rest of the patients started peritoneal dialysis within 2-6 weeks of catheter placement. None of the patients had bleeding related to arterial injury as ultrasound was able to visualize the epigastric artery. Our experience shows that ultrasound-fluoroscopic technique is minimally invasive and allows for accurate assessment of the entry into the abdominal cavity. This technique can avoid the risk of vascular injury altogether.

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Section: Discussionmentioning

confidence: 99%

Ultrasound/Fluoroscopy‐Assisted Placement of Peritoneal Dialysis Catheters

Maya

2007

Seminars in Dialysis

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“…The peritoneal cavity was punctured with a 16-G cannula under percutaneous ultrasound guidance using a 7.5-Mhz probe. The site of percutaneous approach was selected according to Orsi et al 45 A guide-wire was inserted under fluoroscopic guidance through the cannula and advanced into the cavity. An introducer was advanced over the guide-wire and the percutaneous catheter (Quinton Curl Cath (catalog no.…”

Section: Treatmentmentioning

confidence: 99%

Phase-I clinical trial of IL-12 plasmid/lipopolymer complexes for the treatment of recurrent ovarian cancer

Anwer¹,

Barnes

Fewell³

et al. 2009

Gene Ther

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A phase-I trial to assess the safety and tolerability of human interleukin-12 (IL-12) plasmid (phIL-12) formulated with a synthetic lipopolymer, polyethyleneglycol-polyethyleneimine-cholesterol (PPC), was conducted on women with chemotherapy-resistant recurrent ovarian cancer. A total of 13 patients were enrolled in four dose-escalating cohorts and treated with 0.6, 3, 12 or 24 mg m À2 of the formulated plasmid once every week for 4 weeks. Administration of phIL-12/PPC was generally safe and well-tolerated. Common side effects included low-grade fever and abdominal pain. Stable disease and reduction in serum CA-125 levels were clinically observed in some patients. Measurable levels of IL-12 plasmid were detectable in PF samples collected throughout the course of phIL-12/PPC treatment. In comparison, serum samples either did not contain detectable amounts of plasmid DNA or contained o1% of the amount found in the corresponding PF samples. Treatment-related increases in IFN-g levels were observed in PF but not in serum. These data demonstrate that IL-12 gene delivery with a synthetic delivery system is feasible for ovarian cancer patients.

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“…Totally implanted ports are more cosmetically appealing to the patient because the port is placed under the skin. 6,7 Intraoperative and percutaneous intraperitoneal port placement in patients with ascites have previously been reported. We describe our experience placing percutaneous intraperitoneal ports in the absence of ascites using image guidance.…”

mentioning

confidence: 99%