Regional chemotherapy devices: Effect of experience and anatomy on complications

Kurtis A. Campbell, R. Cartland Burns, James V. Sitzmann, Pamela A Lipsett, Louise B. Grochow, John E. Niederhuber

Research output: Contribution to journalArticle

Abstract

Purpose: Regional hepatic arterial infusion (HAI) devices have been used for 17 years, but reports of unacceptably high complication rates have led to controversy about their use. Inadequate or misdirected infusion has been reported to occur in up to 45% of patients. We evaluated whether surgeon experience or presence of variant arterial anatomy related to risk of coagulation. Materials and Methods: We reviewed 70 patients undergoing placement of HAI catheters. Surgeons were classed as experienced after 10 procedures and arterial anatomy was evaluated angiographically with confirmation at operation. Complications were categorized as technical (17%) or chemotherapy-related (16%). Results: Inexperienced surgeons had a technical complication rate of 37% (80% of the patients involved had standard anatomy), while experienced surgeons had a technical complication rate of 7% (P <.01). Experienced surgeons had no complications in patients with standard anatomy, while inexperienced surgeons had a 42% (eight of 19) complication rate in similar patients (P <.01). Conclusion: We conclude that technical complications are closely associated with surgeon experience and arterial anatomy.

Original languageEnglish (US)
Pages (from-to)822-826
Number of pages5
JournalJournal of Clinical Oncology
Volume11
Issue number5
StatePublished - 1993
Externally publishedYes

Fingerprint

Anatomy
Drug Therapy
Equipment and Supplies
Intra Arterial Infusions
Liver
Surgeons
Catheters

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Campbell, K. A., Cartland Burns, R., Sitzmann, J. V., Lipsett, P. A., Grochow, L. B., & Niederhuber, J. E. (1993). Regional chemotherapy devices: Effect of experience and anatomy on complications. Journal of Clinical Oncology, 11(5), 822-826.

Regional chemotherapy devices : Effect of experience and anatomy on complications. / Campbell, Kurtis A.; Cartland Burns, R.; Sitzmann, James V.; Lipsett, Pamela A; Grochow, Louise B.; Niederhuber, John E.

In: Journal of Clinical Oncology, Vol. 11, No. 5, 1993, p. 822-826.

Research output: Contribution to journalArticle

Campbell, KA, Cartland Burns, R, Sitzmann, JV, Lipsett, PA, Grochow, LB & Niederhuber, JE 1993, 'Regional chemotherapy devices: Effect of experience and anatomy on complications', Journal of Clinical Oncology, vol. 11, no. 5, pp. 822-826.
Campbell KA, Cartland Burns R, Sitzmann JV, Lipsett PA, Grochow LB, Niederhuber JE. Regional chemotherapy devices: Effect of experience and anatomy on complications. Journal of Clinical Oncology. 1993;11(5):822-826.
Campbell, Kurtis A. ; Cartland Burns, R. ; Sitzmann, James V. ; Lipsett, Pamela A ; Grochow, Louise B. ; Niederhuber, John E. / Regional chemotherapy devices : Effect of experience and anatomy on complications. In: Journal of Clinical Oncology. 1993 ; Vol. 11, No. 5. pp. 822-826.
@article{c2d7b22360574e19af1cc986dc220c22,
title = "Regional chemotherapy devices: Effect of experience and anatomy on complications",
abstract = "Purpose: Regional hepatic arterial infusion (HAI) devices have been used for 17 years, but reports of unacceptably high complication rates have led to controversy about their use. Inadequate or misdirected infusion has been reported to occur in up to 45{\%} of patients. We evaluated whether surgeon experience or presence of variant arterial anatomy related to risk of coagulation. Materials and Methods: We reviewed 70 patients undergoing placement of HAI catheters. Surgeons were classed as experienced after 10 procedures and arterial anatomy was evaluated angiographically with confirmation at operation. Complications were categorized as technical (17{\%}) or chemotherapy-related (16{\%}). Results: Inexperienced surgeons had a technical complication rate of 37{\%} (80{\%} of the patients involved had standard anatomy), while experienced surgeons had a technical complication rate of 7{\%} (P <.01). Experienced surgeons had no complications in patients with standard anatomy, while inexperienced surgeons had a 42{\%} (eight of 19) complication rate in similar patients (P <.01). Conclusion: We conclude that technical complications are closely associated with surgeon experience and arterial anatomy.",
author = "Campbell, {Kurtis A.} and {Cartland Burns}, R. and Sitzmann, {James V.} and Lipsett, {Pamela A} and Grochow, {Louise B.} and Niederhuber, {John E.}",
year = "1993",
language = "English (US)",
volume = "11",
pages = "822--826",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "5",

}

TY - JOUR

T1 - Regional chemotherapy devices

T2 - Effect of experience and anatomy on complications

AU - Campbell, Kurtis A.

AU - Cartland Burns, R.

AU - Sitzmann, James V.

AU - Lipsett, Pamela A

AU - Grochow, Louise B.

AU - Niederhuber, John E.

PY - 1993

Y1 - 1993

N2 - Purpose: Regional hepatic arterial infusion (HAI) devices have been used for 17 years, but reports of unacceptably high complication rates have led to controversy about their use. Inadequate or misdirected infusion has been reported to occur in up to 45% of patients. We evaluated whether surgeon experience or presence of variant arterial anatomy related to risk of coagulation. Materials and Methods: We reviewed 70 patients undergoing placement of HAI catheters. Surgeons were classed as experienced after 10 procedures and arterial anatomy was evaluated angiographically with confirmation at operation. Complications were categorized as technical (17%) or chemotherapy-related (16%). Results: Inexperienced surgeons had a technical complication rate of 37% (80% of the patients involved had standard anatomy), while experienced surgeons had a technical complication rate of 7% (P <.01). Experienced surgeons had no complications in patients with standard anatomy, while inexperienced surgeons had a 42% (eight of 19) complication rate in similar patients (P <.01). Conclusion: We conclude that technical complications are closely associated with surgeon experience and arterial anatomy.

AB - Purpose: Regional hepatic arterial infusion (HAI) devices have been used for 17 years, but reports of unacceptably high complication rates have led to controversy about their use. Inadequate or misdirected infusion has been reported to occur in up to 45% of patients. We evaluated whether surgeon experience or presence of variant arterial anatomy related to risk of coagulation. Materials and Methods: We reviewed 70 patients undergoing placement of HAI catheters. Surgeons were classed as experienced after 10 procedures and arterial anatomy was evaluated angiographically with confirmation at operation. Complications were categorized as technical (17%) or chemotherapy-related (16%). Results: Inexperienced surgeons had a technical complication rate of 37% (80% of the patients involved had standard anatomy), while experienced surgeons had a technical complication rate of 7% (P <.01). Experienced surgeons had no complications in patients with standard anatomy, while inexperienced surgeons had a 42% (eight of 19) complication rate in similar patients (P <.01). Conclusion: We conclude that technical complications are closely associated with surgeon experience and arterial anatomy.

UR - http://www.scopus.com/inward/record.url?scp=0027214877&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027214877&partnerID=8YFLogxK

M3 - Article

C2 - 8387575

AN - SCOPUS:0027214877

VL - 11

SP - 822

EP - 826

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 5

ER -