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

Abstract

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...

Catheter-related Complications with Totally Implantable Venous Access Devices in Patients with Gynecologic Malignancies

“…The rate of TIVAD-related thrombosis found in this study (4.1%) is within the range of 1.5 up to 16.4% reported in the current literature [2,5,11,[13][14][15][16][17][18]. Likewise, the observed incidence of the complication "venous malposition" (3.1%) is in line with previous studies [13,[16][17].…”

“…In total, pneumothorax occurred in only 1.9% of patients (n = 12), and in only 4 of these patients a thoracic drainage was required. Reviewing the literature showed similar low rates (between 0.4% and 3.4%) of pneumothoraces after TIVAD implantation in ST [2,[12][13][16][17].…”

Portkatheterimplantation an der Universitätsfrauenklinik Ulm – Retrospektive Datenauswertung vier Jahre nach Einführung einer neuen Technik

“…von Komplikationen durch die Operation selbst differenziert werden. Andere Quellen verwenden -wie auch hier in dieser Arbeit -keine genauen Zeitangaben für die Eingrenzung von aufgetretenen Komplikationen, sondern sprechen vielmehr von Früh-und Spätkomplikationen im Allgemeinen [12,14,15]. Auch das Auftreten der Komplikationen Pneumothorax, Infektion, venöse Fehllage, oder arterielle Fehlpunktion war nicht signifikant mit der Therapiesituation (kurativ/nicht kurativ) assoziiert (alle p > 0,3).…”