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Retrospective evaluation of 498 venous access port implantations and complications in adult patients

Year 2019, Volume: 12 Issue: 2, 209 - 214, 28.05.2019
https://doi.org/10.31362/patd.401256

Abstract

Purpose: We intended to report our
experience of 498 implantable chest ports with successful percutaneous
radiologic placement via internal jugular vein in oncologic patients.

Materials and Methods: We evaluated
data of 498 patients who underwent imaging guided percutaneous venous access
ports implantation during a 2-year period retrospectively.

Results: The mean age of the subjects was 55
(21-84), with a male preponderance (61.8%, 303). The devices were successfully
implanted in all cases. We did not experience any early complications including
pneumothorax, inadvertent arterial puncture, plexus irritation, and air
embolism. The overall complication rate was 3.4%.







Conclusion: Imaging guided
implantation of chest ports, having a considerably lower complication rate
without any early major complications, seems superior to surgical placement. 

References

  • 1.Morris SL, Jaques PF, Mauro MA. Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology 1992;184:149-151.
  • 2.Funaki B, Szymski GX, Hackworth CA, Rosenblum JD, Burke R, Chang T, et al. Radiologic placement of subcutaneous infusion chest ports for long-term central venous access. AJR Am J Roentgenol 1997;169:1431-1434.
  • 3.Dede D, Akmangit I, Yildirim ZN, Sanverdi E, Sayin B. Ultrasonography and fluoroscopy-guided insertion of chest ports. Eur J Surg Oncol 2008;34:1340-1343.
  • 4.Namyslowski J, Patel NH. Central venous access: A new task for interventional radiologists. Cardiovasc Intervent Radiol 1999;22:355-368.
  • 5.Teichgraber UK, Benter T, Gebel M, Manns MP. A sonographically guided technique for central venous access. AJR Am J Roentgenol 1997;169:731-733.
  • 6.Denys BG, Uretsky BF. Anatomical variations of internal jugular vein location: impact on central venous access. Crit Care Med 1991;19:1516-1519.
  • 7.Hind D, Calvert N, McWilliams R, Davidson A, Paisley S, Beverley C, et al. Ultrasonic locating devices for central venous cannulation: meta-analysis. Bmj 2003;327:361.
  • 8.Tan PL, Gibson M. Central venous catheters: the role of radiology. Clin Radiol 2006;61:13-22.
  • 9.Trerotola SO, Kuhn-Fulton J, Johnson MS, Shah H, Ambrosius WT, Kneebone PH. Tunneled infusion catheters: increased incidence of symptomatic venous thrombosis after subclavian versus internal jugular venous access. Radiology 2000;217:89-93.
  • 10.Yip D, Funaki B. Subcutaneous chest ports via the internal jugular vein. A retrospective study of 117 oncology patients. Acta Radiol 2002;43:371-375.
  • 11.Onders RP, Shenk RR, Stellato TA. Long-term central venous catheters: size and location do matter. Am J Surg 2006;191:396-399.
  • 12.Bold RJ, Winchester DJ, Madary AR, Gregurich MA, Mansfield PF. Prospective, randomized trial of Doppler-assisted subclavian vein catheterization. Arch Surg 1998;133:1089-1093.
  • 13.Ignatov A, Hoffman O, Smith B, Fahlke J, Peters B, Bischoff J, et al. An 11-year retrospective study of totally implanted central venous access ports: complications and patient satisfaction. Eur J Surg Oncol 2009;35:241-246.
  • 14.Lorch H, Zwaan M, Kagel C, Weiss HD. Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol 2001;24:180-184.
  • 15.Cil BE, Canyigit M, Peynircioglu B, Hazirolan T, Carkaci S, Cekirge S, et al. Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol 2006;12:93-98.
  • 16. Gebauer B, El-Sheik M, Vogt M, Wagner HJ. Combined ultrasound and fluoroscopy guided port catheter implantation--high success and low complication rate. European journal of radiology 2009;69:517-522.
  • 17.Groeger JS, Lucas AB, Thaler HT, Friedlander-Klar H, Brown AE, Kiehn TE, et al. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 1993;119:1168-1174.

Erişkin Hastalarda 498 Deri Altı Port Kateter Uygulamaları ve Komplikasyonlarının Retrospektif Değerlendirilmesi

Year 2019, Volume: 12 Issue: 2, 209 - 214, 28.05.2019
https://doi.org/10.31362/patd.401256

Abstract

Amaç: Onkoloji
hastalarında  kemoterapi ajanlarının
kullanılması, bu hastalarda uygun desteğin de sağlanabileceği santral yolların
kullanımını zaruri kılmıştır. Biz girişimsel radyoloji ünitesinde erişkin
hastalara başarıyla takılan 498 port kateterin, erken  ve geç komplikasyonlarını retrospektif olarak
değerlendirdik. Port kateterleri takan ve kullanan sağlık personelinin
karşılaşabileceği  komplikasyonları
öğrenmesini, dikkatli ve hijyenik kullanımının önemini bildirmeyi amaçladık.

Metot: Çalışmaya girişimsel
radyoloji bölümümüzde ultrason ve floroskopi eşliğinde  internal juguler ven yoluyla  iki yıl boyunca  498 
hastaya  perkütanöz venöz girişle
taktığımız port kataterleri retrospektif
olarak  erken ve geç komplikasyonlarını
değerlendirdik. Port kateter takılan hastaların yaş, cinsiyet, primer tanısı,
takılan portun cinsi, anestezinin türü, erken ve geç komplikasyonları,
eksplantasyon nedenleri saptandı ve bilgisayar ortamına kaydedildi. İşlemden
sonraki 2 hafta içerisindeki komplikasyonlar erken, daha sonraki
komplikasyonlar geç olarak kabul edildi.

Bulgular: Hastaların
195’i kadın (%39.2), 303’ü erkekti (%60.8). Hastaların asıl tanılarına
bakıldığında en büyük grubu 413 hasta (%82.9) ile gastrointestinal sistem
maligniteleri oluşturmuştu. Başarıyla yerleştirdiğimiz tüm  port kateterlerimizde pnömotoraks, yanlış arteryel
giriş, pleksus irritasyonu ve hava embolisi gibi erken major komplikasyonlar
gelişmedi. Sadece 3 vakada erken dönemde hematom gelişti. Geç
komplikaslarımızın oranı 3.4% idi.

Sonuç: Major
erken komplikasyonlar olmaksızın görüntüleme kılavuzluğunda gögüs duvarına
yerleştirilen port kateterlerin, düşük komplikasyon oranına sahip olması
nedeniyle cerrahi tekniğe göre üstünlük göstermektedir.









 

References

  • 1.Morris SL, Jaques PF, Mauro MA. Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology 1992;184:149-151.
  • 2.Funaki B, Szymski GX, Hackworth CA, Rosenblum JD, Burke R, Chang T, et al. Radiologic placement of subcutaneous infusion chest ports for long-term central venous access. AJR Am J Roentgenol 1997;169:1431-1434.
  • 3.Dede D, Akmangit I, Yildirim ZN, Sanverdi E, Sayin B. Ultrasonography and fluoroscopy-guided insertion of chest ports. Eur J Surg Oncol 2008;34:1340-1343.
  • 4.Namyslowski J, Patel NH. Central venous access: A new task for interventional radiologists. Cardiovasc Intervent Radiol 1999;22:355-368.
  • 5.Teichgraber UK, Benter T, Gebel M, Manns MP. A sonographically guided technique for central venous access. AJR Am J Roentgenol 1997;169:731-733.
  • 6.Denys BG, Uretsky BF. Anatomical variations of internal jugular vein location: impact on central venous access. Crit Care Med 1991;19:1516-1519.
  • 7.Hind D, Calvert N, McWilliams R, Davidson A, Paisley S, Beverley C, et al. Ultrasonic locating devices for central venous cannulation: meta-analysis. Bmj 2003;327:361.
  • 8.Tan PL, Gibson M. Central venous catheters: the role of radiology. Clin Radiol 2006;61:13-22.
  • 9.Trerotola SO, Kuhn-Fulton J, Johnson MS, Shah H, Ambrosius WT, Kneebone PH. Tunneled infusion catheters: increased incidence of symptomatic venous thrombosis after subclavian versus internal jugular venous access. Radiology 2000;217:89-93.
  • 10.Yip D, Funaki B. Subcutaneous chest ports via the internal jugular vein. A retrospective study of 117 oncology patients. Acta Radiol 2002;43:371-375.
  • 11.Onders RP, Shenk RR, Stellato TA. Long-term central venous catheters: size and location do matter. Am J Surg 2006;191:396-399.
  • 12.Bold RJ, Winchester DJ, Madary AR, Gregurich MA, Mansfield PF. Prospective, randomized trial of Doppler-assisted subclavian vein catheterization. Arch Surg 1998;133:1089-1093.
  • 13.Ignatov A, Hoffman O, Smith B, Fahlke J, Peters B, Bischoff J, et al. An 11-year retrospective study of totally implanted central venous access ports: complications and patient satisfaction. Eur J Surg Oncol 2009;35:241-246.
  • 14.Lorch H, Zwaan M, Kagel C, Weiss HD. Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol 2001;24:180-184.
  • 15.Cil BE, Canyigit M, Peynircioglu B, Hazirolan T, Carkaci S, Cekirge S, et al. Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol 2006;12:93-98.
  • 16. Gebauer B, El-Sheik M, Vogt M, Wagner HJ. Combined ultrasound and fluoroscopy guided port catheter implantation--high success and low complication rate. European journal of radiology 2009;69:517-522.
  • 17.Groeger JS, Lucas AB, Thaler HT, Friedlander-Klar H, Brown AE, Kiehn TE, et al. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 1993;119:1168-1174.
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Tuğba Eldeş 0000-0001-8431-9534

İlkay Akmangit This is me

Doğan Dede This is me 0000-0002-8542-3808

Nilgün Yıldırım This is me 0000-0001-6506-0336

Bige Sayın This is me 0000-0003-2824-5942

Perihan Polattaş This is me 0000-0003-0673-7540

Publication Date May 28, 2019
Submission Date March 5, 2018
Acceptance Date December 19, 2018
Published in Issue Year 2019 Volume: 12 Issue: 2

Cite

AMA Eldeş T, Akmangit İ, Dede D, Yıldırım N, Sayın B, Polattaş P. Erişkin Hastalarda 498 Deri Altı Port Kateter Uygulamaları ve Komplikasyonlarının Retrospektif Değerlendirilmesi. Pam Med J. May 2019;12(2):209-214. doi:10.31362/patd.401256

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