Onkolojik Hastalarda İnternal Jügüler Ven Yoluyla Venöz Port Implantasyonu- Tek Bir Genel Cerrahın Deneyimi

Year 2023, Volume: 10 Issue: 3, 171 - 176, 19.12.2023

Muharrem Öner

https://doi.org/10.47572/muskutd.1328420

Abstract

Santral venöz erişim tekrarlayan kemoterapi, hemodiyaliz, kan transfüzyonları, total parenteral beslenme ve kan örnekleri alımı gereken onkoloji hastaları için kritik öneme sahiptir. Bu çalışma, genel anestezi altında ve ultrasonografi ve floroskopi rehberliğinde bir genel cerrahın Totally Implantable Access Port (TIAP) implantasyon deneyimini sunmayı ve erken ve geç komplikasyonları değerlendirmeyi amaçlamaktadır. Bir retrospektif çalışma, Ocak 2020 ile Aralık 2022 tarihleri arasında TIAP implantasyonu yapılan hastalar üzerinde yürütüldü. Solid tümörler için intravenöz kemoterapi uygulanan hastalar dahil edildi. İşlemlerin tamamı tek bir genel cerrah tarafından gerçekleştirdi. Bütün hastalara genel anestezi uygulandı ve bir perkütan Seldinger tekniği kullanıldı. Erken ve geç komplikasyonlar izlendi ve ilgili veriler toplandı. Çalışma, yaş ortancası 46 yıl, çoğunluğu kadın (%65.1) olan 186 hasta içeriyordu. Genel başarı oranı %99.5 idi. Erken ve geç komplikasyonlar sırasıyla vakaların %1.6'sında ve %5.9'unda meydana geldi. En yaygın geç komplikasyonlar port yerinde enfeksiyon (%1.6) ve semptomatik tromboz (%1.6) idi. Bir hastada oluşan port migrasyonu aynı gün düzeltildi. Pnömotoraks vakası gözlenmedi. Kemoterapisi sonlanan 92 hastada port çıkarıldı. TIAP implantasyonunun ultrasonografi ve floroskopi rehberliğinde ve genel anestezi altında bir genel cerrah tarafından gerçekleştirilmesi durumunda yüksek başarı oranı ve düşük komplikasyon oranı söz konusudur. Bu bulgular, özel bir hastane ortamında ve genel anestezi altında TIAP implantasyonunun güvenli ve etkili olduğunu vurgulamaktadır. Çalışma, genel cerrahların onkoloji hastaları için etkili ve güvenli bir şekilde TIAP implantasyonunu gerçekleştirmelerini destekleyen bir kanıt olarak değerlendirilebilir. Böylelikle farklı klinik ortamlarda daha yaygın olarak kullanılmasını sağlayabilir.

Keywords

Genel Anestezi, Genel Cerrah, Hastane Onkoloji Servisi, Vasküler Erişim Cihazı

Implantation of Totally Implantable Access Ports via The Internal Jugular Vein in Oncological Patients - A Single General Surgeon Experience

Abstract

Central venous access is pivotal for patients undergoing repetitive chemotherapy, hemodialysis, blood transfusions, total parenteral nutrition, and blood tests. This study aims to present the single-center experience of a general surgeon in Totally Implantable Access Port (TIAP) implantation under general anesthesia using ultrasonography and fluoroscopy guidance and assess early and late complications. A retrospective study was conducted on patients who underwent TIAP implantation between January 2020 and December 2022. Patients eligible for intravenous chemotherapy with solid tumors were included. A single general surgeon performed the procedures. General anesthesia was administered in all patients, and a percutaneous Seldinger technique was utilized. Early and late complications were monitored, and relevant data were collected. The study comprised 186 patients with a median age of 46, predominantly female (65.1%). The overall success rate was 99.5%. Early and late complications occurred in 1.6% and 5.9% of cases. The most common late complications were pocket infection (1.6%) and symptomatic thrombosis (1.6%). Port migration occurred in one patient but was promptly corrected. No pneumothorax cases were observed. Port removal was performed in 92 patients upon chemotherapy completion. Implantation of TIAPs under general anesthesia, guided by ultrasound and fluoroscopy, resulted in a high success rate and low complication rate when performed by a skilled general surgeon. These findings underscore the safety and efficacy of TIAP implantation under general anesthesia in a private hospital setting. The study contributes to the growing body of evidence supporting general surgeons in providing effective and safe TIAP implantation for oncology patients, potentially expanding its availability in diverse clinical settings.

Keywords

General Anesthesia, General Surgeon, Hospital Oncology Service, Vascular Access Devices

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