Intraperitoneal chemotherapy: introduction of a new "single use" delivery system--a preliminary report.

Intraperitoneal administration of chemotherapy in ovarian cancer is currently under investigation. In this preliminary report we introduce the "Veress-needle" as a "single-use" delivery system of intraperitoneal chemotherapy. A total of 22 infusions in 7 patients revealed no major complications, and during 4 infusions only minor side effects were noted. The technique described seems to fulfill the need for a safe, reliable, and acceptable delivery system of intraperitoneal chemotherapy.

T-tube suction drainage and/or prophylactic two-dose metronidazole in abdominal hysterectomy.

The efficacy of a two-dose perioperative course of rectally administered metronidazole and/or suction drainage of the vaginal vault in preventing febrile and infectious morbidity was evaluated in a randomized study of 198 patients undergoing abdominal hysterectomy. When compared with the control values, the incidence of febrile morbidity was significantly reduced (from 49% to 10%, 24.5%, and 10% respectively) in the groups treated with metronidazole, T-tube suction drainage, and a combination of the two prophylactic measures. The incidence of infectious morbidity was significantly reduced by using prophylactic metronidazole alone or in combination with suction drainage, but the reduction was most significant in the group treated with metronidazole alone. In the group managed with suction drainage alone, no reduction in infectious morbidity was found. The rate of postoperative urinary tract infection was significantly lower in the group treated with metronidazole alone as compared with the control group. No side effects of metronidazole were encountered.

Puerperal lactation inhibition with a novel 8 alpha-aminoergoline (CU 32-085).

The clinical efficacy of CU 32-085, a novel ergoline derivative, in puerperal lactation inhibition was investigated in 41 healthy postpartum women and compared with serum concentrations of prolaction (PRL) and CU 32-085. The women received 0.5 mg CU 32-085 twice daily for 14 days. In 40 women (i.e. 97%) treatment with CU 32-085 successfully inhibited lactation; slight to moderate breast activity appearing during the first few days receded spontaneously. 1 woman experienced full milk let-down on day 5 of treatment. No rebound lactational phenomena were recorded. 5 h after the initial dose, mean serum PRL concentrations decreased by 82% (from 169 to 30 ng/ml), and PRL values remained at that level during the course of treatment. The mean serum concentrations of CU 32-085 showed an inverse pattern compared to PRL. CU 32-085 was well tolerated, with transient slight to moderate dizziness, headache and nausea reported by 12 women (29%) following the initial dose. These disappeared after an average of 3 h. Routine safety chemistries remained within the normal range, and no statistically significant differences between the treatment group and the control group (25 normal nursing postpartum women) were encountered. It is concluded that CU 32-085, a potent dopamine agonist, is an effective and well-tolerated treatment in the indication of postpartum lactation inhibition.

Iatrogenic femoral neuropathy subsequent to abdominal hysterectomy: incidence and prevention.

In a prospective study femoral neuropathy occurred in 17 of 147 patients who underwent elective total abdominal hysterectomy, resulting in an overall incidence of 11.6%. The neuropathy was associated with the use of self-retaining retractors of various types. No other contributing factors were found. The duration of complaints ranged from 3 to 65 days. Spontaneous recovery did occur in 15 of 17 patients and, although residual sensory symptoms were noted in 2 patients, no serious sequelae have been observed. Knowledge of the problem is mandatory for prevention. Careful use of any self-retaining retractor, especially one with large lateral blades, is recommended. The prognosis usually is fairly good.