Document Detail


Technical complications and durability of hepatic artery infusion pumps for unresectable colorectal liver metastases: an institutional experience of 544 consecutive cases.
MedLine Citation:
PMID:  15978444     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hepatic arterial infusion pump chemotherapy is an important component in the treatment of patients with hepatic metastases. Successful use of a hepatic arterial infusion pump requires a low technical complication rate. We evaluated the complications and longterm durability of these devices at our institution. STUDY DESIGN: Between April 1986 and March 2001, 544 patients underwent hepatic arterial infusion pump placement for treatment of unresectable colorectal liver metastases. Patient- and pump-related data were collected by chart review. Pump-related complications, duration of pump function, and overall patient survival were recorded. RESULTS: Median patient survival was 24 months after pump placement. The incidences of pump failure were 9% at 1 year and 16% at 2 years. Pump complications occurred in 120 (22%) of the patients. Complications that occurred early after operation (< 30 days) were more likely to be salvaged than those occurring late (70% versus 30%, p < 0.001). Increased pump complication rates occurred in the setting of variant arterial anatomy (28% versus 19%, p = 0.02), when the catheter was inserted into a vessel other than the gastroduodenal artery (42% versus 21%, p = 0.004), if the pump was placed during the first half of the study period (1986 to 1993, 25% versus 1994 to 2001, 18%; p = 0.05), and if the surgeon had performed fewer than 25 earlier procedures (< 25, 31% versus > or = 25, 19%; p < 0.002). CONCLUSIONS: In this large single institution experience, pump-related complications were low, the majority of early pump complications were salvaged, and pump complication rates improved as institutional experience accumulated. Longterm durability of pump function was excellent.
Authors:
Peter J Allen; Aviram Nissan; Antonio I Picon; Nancy Kemeny; Paul Dudrick; Leah Ben-Porat; Joseph Espat; Alexander Stojadinovic; Alfred M Cohen; Yuman Fong; Philip B Paty
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Surgeons     Volume:  201     ISSN:  1072-7515     ISO Abbreviation:  J. Am. Coll. Surg.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-27     Completed Date:  2005-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431305     Medline TA:  J Am Coll Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-65     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Catheterization / instrumentation
Colectomy
Colorectal Neoplasms / pathology
Equipment Design
Equipment Failure
Female
Follow-Up Studies
Hepatic Artery* / pathology
Humans
Infusion Pumps, Implantable* / adverse effects
Length of Stay
Liver Neoplasms / drug therapy,  secondary*
Longitudinal Studies
Male
Middle Aged
Retrospective Studies
Survival Rate
Thrombosis / etiology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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