Langfristige zentralvenöse Zugänge und deren Komplikationsmanagement

Teichgräber, Ulf; Gebauer, Bernhard; Benter, T.; Wagner, Jasmin

doi:10.1055/s-2004-813258

Cited by 29 publications

(19 citation statements)

References 14 publications

(15 reference statements)

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“…8 Early complications of subclavian vein puncture include pneumothorax, hemothorax, air embolism, and arterial perforation. 9 The incidence of pneumothorax in subclavian vein punctures is 1-4%. The most important factors contributing to this complication are the experience of the surgeon and the attention paid to the anatomical landmarks.…”

Section: Discussionmentioning

confidence: 99%

Subclavian Venous Port Catheter Implantation in General Surgery: 238 Cases From a Single Center

Güner¹,

Tümay²,

Zorluoğlu³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : In general surgery, venous port catheters (VPC) are useful for maintaining long-term parenteral nutrition and protecting the venous system from trauma due to repeated access, such as in cancer patients. However, the most common users of this technique are cardiovascular surgeons and radiologists. The most popular route for long-term central venous catheterization is the subclavian vein, although it carries a 12% rate of peri-procedural complications. The aim of this retrospective study was to investigate the early and late complications associated with percutaneous insertion of VPCs by general surgeons and to compare the complication rates with those reported in the literature. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : We investigated clinical and demographical data of 238 cancer patients who underwent totally implantable, indwelling, subclavian port catheterization in our General Surgery Clinic between March 2006 and December 2009. The port catheters implanted to the patients by the two experienced surgeons, using the same technique. R Re es su ul lt ts s: : One patient developed pneumothorax (0.42%) and in 4 (1.68%) patients inadvertent subclavian artery puncture was occurred. Catheter migration developed in 3 (1.26%) cases, two caused by spontaneous catheter rupture (Pinch off Syndrome) and the other one caused by catheter disconnection. C Co on n--c cl lu us si io on n: : In experienced hands, percutaneous implantation of an indwelling port catheter through the subclavian vein is safe with low complications and a high success rate. Good patient monitoring and a multidisciplinary approach are important for management of any likely complications.K Ke ey y W Wo or rd ds s: : Catheterization, central venous; catheters, indwelling Ö ÖZ ZE ET T A Am ma aç ç: : Venöz port kateter, uzun süreli parenteral nütrisyon ihtiyacı olan ve kanser hastaları gibi sıkça venöz girişim yapılan hastalarda venöz sistemi travmadan korumak için kullanılan faydalı bir uygulamadır. Hastaların yaklaşık %12'sinde perioperatif komplikasyonlar ortaya çıksa da, subklavyen ven kullanımı uzun dönem santral venöz kateterizasyon için en popüler yoldur. Bu teknik sıklıkla kardiyovasküler cerrahlar ve girişimsel radyologlar tarafından uygulanmaktadır. Retrospektif çalışmamızın amacı, klinik tecrübemizi okuyucularla paylaşmak ve literatür eşliğinde gelişen erken ve geç dönem komplikasyonları irdelemektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Mart 2006-Aralık 2009 tarihleri arasında Acıbadem Bursa Hastanesi Genel Cerrahi kliniğinde total implante edilebilir kalıcı subklavien port katater takılan 238 kanser hastasına ait klinik ve demografik veriler retrospektif olarak incelendi. Bu çalışmaya dahil edilen hastalara implante edilen port kataterler; bu konuda daha önceden deneyim kazanmış iki cerrah tarafından aynı teknikle yapıldı. B Bu ul lg gu ul la ar r: : Bir hastada pnömotoraks (% 0,42) dört hastada (%1,68) arter ponksiyonu görüldü. Üç olguda kateter migra...

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Section: Discussionmentioning

confidence: 99%

Subclavian Venous Port Catheter Implantation in General Surgery: 238 Cases From a Single Center

Güner¹,

Tümay²,

Zorluoğlu³

et al. 2013

Turkiye Klinikleri J Med Sci

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“…Port complications can be subdivided into procedural complications, catheter-related complications and vascular complications. Short-term complications include accidental arterial puncture, hematoma, air embolism, pneumothorax or vessel perforation [60], but these complications are rare in modern oncology. Surgical complications arise in <2 % of cases in experienced hands [61].…”

Section: Development Of Port Devicesmentioning

confidence: 99%

Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review

Inoue

Kusunoki

2013

Surg Today

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With the recent advances in chemotherapy for colorectal cancer, the prognosis for patients with metastatic colorectal cancer has been significantly improved. The development of the implantable port system has also enabled patients to receive multiagent chemotherapy with a more satisfactory quality of life. Historically, chemotherapy using implantable port systems was begun to obtain an oncological benefit in the treatment of locoregional cancer. In the 1950s, there was an increasing interest in perfusion techniques for the application of chemotherapeutic agents, such as nitrogen mustard, in the locoregional treatment of metastatic cancer. Among them, the treatment of liver metastasis has interested oncologists for many years. On the other hand, implantable devices were developed during the intervening decades that have enabled patients with colorectal cancer with liver metastases to be treated effectively using hepatic arterial infusion; which became more common in the 1980s. The treatment of metastatic colorectal cancer increasingly requires a multimodal approach and multiple treatment options based not on convenience, but in terms of personalization and efficacy. Therefore, it is important to optimize the pharmacokinetics of chemotherapeutic agents. Implantable port systems for colorectal cancer patients have been essential for oncological practice, and the importance of these systems will remain unchanged in the near future.

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“…Unlike other implants, these devices are used repeatedly by many physicians and nurses and require transcutaneous puncture whenever an infusion is given. Improper use can lead to complications such as infection, extravasation, necrosis, or material failure (5). All persons treating cancer patients with port systems must assume responsibility for the meticulous care of the system.…”

Section: Definitionmentioning

confidence: 99%

Central Venous Port Systems as an Integral Part of Chemotherapy

Teichgräber¹,

Pfitzmann²,

Hofmann³

2011

Deutsches Ärzteblatt International

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The treatment, follow-up care, and rehabilitation of cancer patients are interdisciplinary tasks. Optimal treatment and complication avoidance require a collaborative effort of all of the involved specialists-not just the physician implanting the port system, but also the oncologists, nutritionists, visiting nurses, and other home health care providers. Continuing medical education, too, plays a role in improving outcomes.

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Langfristige zentralvenöse Zugänge und deren Komplikationsmanagement

Cited by 29 publications

References 14 publications

Subclavian Venous Port Catheter Implantation in General Surgery: 238 Cases From a Single Center

Subclavian Venous Port Catheter Implantation in General Surgery: 238 Cases From a Single Center

Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review

Central Venous Port Systems as an Integral Part of Chemotherapy

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