FIELD: medicine; oncology.
SUBSTANCE: cannulas are inserted into the right jugular vein and into the right femoral vein. Balloon catheters are inserted through the left femoral vein and the left jugular vein. An occluding balloon catheter is inserted through the lobar branch of the portal vein in the mouth of the portal vein. A balloon catheter is inserted through the left femoral artery into the proper hepatic artery to deliver the chemotherapeutic agent solution into the hepatic arterial pool. A portal vein is catheterized through a free lobar branch of the portal vein, into which a catheter is inserted to supply a solution of a chemotherapeutic agent. Closed bypass and perfusion circuits are used. A solution of t 40 °C containing 300 ml of erythrocyte mass, 700 ml of physiological sodium chloride solution and a cytostatic agent containing Melphalan 1.5 mg per 1 kg of body weight, hypocoagulation is supported by using heparin to maintain the level of ACT of 350–400 sec. At the end of the perfusion, the liver is washed from the chemotherapeutic agent with Gelofusine 1,500 ml.
EFFECT: method provides the possibility of repeated use of chemoperfusion without increasing risks of complications with repeated use, increases overall survival, minimizing the number of surgical manipulations in the abdominal cavity and retroperitoneal space, preserving the physiological blood supply to the liver and provide more complete coverage of tumor tissue having dual or predominantly venous blood supply.
1 cl, 1 dwg, 1 ex
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Authors
Dates
2024-09-11—Published
2023-11-15—Filed