胃癌腹膜转移病人腹腔化疗港并发症发生及危险因素分析

Complications of implanted subcutaneous port for intraperitoneal chemotherapy in gastric cancer patients with peritoneal metastasis and analysis of risk factors of complications

目的:分析腹腔化疗港并发症发生及相关危险因素。方法:回顾性分析我院323例放置腹腔化疗港病人的临床资料,纳入261例胃癌腹膜转移病人。分析腹腔化疗港在胃癌腹膜转移病人腹腔化疗时发生的并发症及其危险因素。结果:261例中59例(22.6%)发生化疗港相关并发症。其中,皮下积液(25例,42.4%)和化疗港感染(16例,27.1%)是发生较多的并发症。其他是港体倾斜翻转(9例,15.3%),化疗港局部切口裂开(7例,11.9%),导管堵塞(1例,1.7%),和皮下转移(1例,1.7%)。化疗港并发症发生的中位时间为化疗港放置后3.0个月。结合Clavien-Dindo分级方法,将化疗港发生的并发症分为1~4个等级。ECOG评分、血清白蛋白水平、置港流程优化及专业团队放置为化疗港并发症发生的独立危险因素(P<0.05)。ECOG评分为唯一影响并发症分级的关联因素(P<0.05)。结论:腹腔化疗港在胃癌腹膜转移病人腹腔化疗中的应用安全可行,发生并发症可控。ECOG评分、血清白蛋白水平、置港方式是否优化及是否专业团队放置为化疗港并发症发生的独立危险因素。

Objective To analyze the port complications and risk factors associated with the port complications in gastric cancer patients with peritoneal metastasis.Methods The medical records of 323 patients with subcutaneous ports implantation for intraperitoneal chemotherapy were retrospectively analyzed and 261 gastric cancer patients with peritoneal metastasis were included.Port complications and risk factors associated with complications were analyzed.Results There were 59(22.6%)cases with port complications associated with intraperitoneal chemotherapy in all included 261 cases.Subcutaneous effusion(25 cases,42.4%)and port infection(16 cases,27.1%)were the main complications,followed by port rotation(9 cases,15.3%),partial port wound dehiscence(7 cases,11.9%),catheter obstruction(1 case,1.7%)and subcutaneous metastasis(1 case,1.7%).The median period between port implantation and occurrence of complications was 3.0 months.Eastern Cooperative Oncology Group(ECOG)score,serum albumin,implantation management optimization and implantation specialized group were independent risk factors for port complications(P<0.05).ECOG score was the only factor that related to the grade of port complications(P<0.05).Conclusions Port implantation would be safe and feasible for gastric cancer patients with peritoneal metastasis who received intraperitoneal chemotherapy.ECOG score,serum albumin,implantation management optimization and specialized group are independent risk factors associated with port complications.