We analyzed the complications of the early postoperative intraperitoneal chemotherapy in 47 patients who underwent gastrectomy for histologically proven gastric cancer.
The leakage of fluid around the catheter insertion site was found in 13 cases of early experiences and could be prevented by a purse string suture at the parietal peritoneum around the catheter. Ten patients complained of moderate to severe abdominal pain which was controlled by administration of mild analgesic in most cases. On the second postoperative day, the volume of the return fluid decreased remarkably and this was not considered as a complication. There were 7 cases of intraperitoneal bleeding but controlled uneventfully by conservative method except one. Bacteriologic study yielded 12 microorganisms in 9 cases. To prevent the intraperitoneal infection, catheter management and fluid exchange must be carried out aseptically. There were 17 minor complications, such as leukopenia, anorexia, ascites, prolonged ileus, and difficulty in removal of catheter. Thorough lavage of peritoneal cavity just prior to the closure of the abdomen and the periodic irrigation of peritoneal cavity through the Tenckhoff catheter before drug instillation would be mandatory to reduce the incidence of the inflow and the outflow obstruction.
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