Surgical technology catheterization hepatic arteri under selective intra-arterial chemotherapy

Abstract

Developed and introduced into clinical practice methods of hepatic artery catheterization through the right gastro-omental artery and (or) the right gastric artery, which let you quickly and without risk of bleeding catheter set for different types of blood supply to the liver for selective intraarterial chemotherapy. After catheterization of hepatic artery own output stump artery with a catheter through a tunnel formed in the round ligament of the liver in kontraperturny puncture in the right upper quadrant and left in this state for the whole period of treatment, or set subcutaneous arterial port. Method angiostomy allow transport of anticancer drugs directly to the target organ, and on the other hand delimit the prepared arterial vessel from the free abdominal cavity. Selective intra-arterial chemotherapy on the described method was performed in 326 patients with liver metastases from colorectal cancer. During or after treatment, complications occurred in 17 patients, accounting for 5.2%. In determining the extent of reactions NCI toxicity scale was used. The proposed method of treatment allows for selective intraarterial combination chemotherapy in patients with different variants of the blood supply to the liver. It is advisable in all cases produce a block lymphadenectomy gate liver exposing the structures of the celiac trunk and cholecystectomy. The proposed sequence of actions in the performance of selective intra-arterial chemotherapy can simultaneously take into account the anatomical variations, as well as to avoid possible mistakes and complications.