Four-Year Study on Subcutaneous Port Catheters in Oncology Patients: Patency, Complications, and Outcomes

Yıl 2024, Cilt: 8 Sayı: 3, 228 - 235, 30.12.2024

Asiye Aslı Gözüaçık Rüzgar , Hakan Öntaş

https://doi.org/10.30565/medalanya.1548606

Öz

Aim: Our primary focus was port patency, postoperative complications, mortality rates, and demographic factors.

Methods: In this extensive four-year study, we examined subcutaneous port catheter placement in 172 oncology patients (111 men, 61 women) between March 2018 and December 2021. We excluded one 10-month-old infant who received a pediatric port catheter.

Results: Patients predominantly underwent jugular intervention via the right internal jugular vein (97%) and occasionally via the left internal jugular vein (3%). On average, the port patency lasted for 375 days, with an overall duration of 432 days. Males had a mean patency of 13.58 months, while females averaged 11.97 months. Notably, bladder cancer patients had the longest port patency (44 months), followed by uterine cancer (35 months) and breast cancer (22.5 months). Among the 171 patients, nine had mild to moderate infections, six had mild ecchymosis-hematoma, and two required early catheter removal due to severe infections. Only one patient had mild pneumothorax that did not necessitate surgery. No major complications, such as hemothorax, nerve injury, neck compression, massive hematoma, blood transfusion, substantial bleeding, port detachment, rupture, or fragment embolism were recorded.

Conclusion: Subcutaneous port catheter placement proved to be safe and effective for patients undergoing chemotherapy, particularly with skilled surgical teams. Procedures via the right internal jugular vein consistently yielded favorable outcomes, with low infection rates, minimal occlusion, stenosis, thrombosis, and complication rates, while maintaining extended port patency. This study underscores the substantial improvement in oncology patients' quality of life by eliminating the challenges associated with frequent peripheral vessel access.

Anahtar Kelimeler

Port catheter, Complications, Intravenous Chemotherapy, Malignancy, Internal Jugular Vein

Onkoloji Hastalarında Subkutan Port Kateterler Üzerine Dört Yıllık Çalışma: Açıklık, Komplikasyonlar ve Sonuçlar

Öz

Amaç: Öncelikli odak noktamız port açıklığı, postoperatif komplikasyonlar, mortalite oranları ve demografik faktörlerdi.

Yöntem: Bu dört yıllık kapsamlı çalışmada, Mart 2018 ve Aralık 2021 tarihleri arasında 172 onkoloji hastasında (111 erkek, 61 kadın) subkutan port kateter yerleştirilmesini inceledik. Pediatrik port kateteri takılan 10 aylık bir bebek hariç tutulmuştur.

Bulgular: Hastalara ağırlıklı olarak sağ internal juguler venden (%97) ve nadiren soldan (%3) juguler girişim uygulandı. Ortalama olarak, port açıklığı 375 gün sürmüş ve toplam süre 432 gün olmuştur. Erkeklerde ortalama açık kalma süresi 13,58 ay iken, kadınlarda ortalama 11,97 aydır. Özellikle, mesane kanseri hastaları en uzun port açıklığına (44 ay) sahipken, bunu rahim kanseri (35 ay) ve meme kanseri (22,5 ay) takip etmiştir. 171 hastanın dokuzunda hafif ila orta derecede enfeksiyon, altısında hafif ekimoz-hematom ve ikisinde ciddi enfeksiyon nedeniyle kateterin erken çıkarılması gerekmiştir. Sadece bir hastada ameliyat gerektirmeyen hafif bir pnömotoraks görülmüştür. Hemotoraks, sinir yaralanması, boyun sıkışması, masif hematom, kan transfüzyonu, ciddi kanama, port ayrılması, rüptür veya fragman embolisi gibi majör komplikasyonlar kaydedilmedi.

Sonuç: Subkütan port kateter yerleştirme işleminin kemoterapi hastaları için, özellikle de deneyimli cerrahi ekiplerle, güvenli ve etkili olduğu kanıtlanmıştır. Sağ internal juguler ven yoluyla yapılan prosedürler, düşük enfeksiyon oranları, minimal oklüzyon, stenoz, tromboz ve komplikasyon oranları ile sürekli olarak olumlu sonuçlar verirken, uzun süreli port açıklığını da korumuştur. Bu araştırma, sık periferik damar erişimiyle ilişkili zorlukları ortadan kaldırarak onkoloji hastalarının yaşam kalitesindeki önemli iyileşmenin altını çizmektedir.

Anahtar Kelimeler

Port Katater, Komplikasyonlar, İntravenöz Kemoterapi, Malignite, Internal Juguler Ven

Kaynakça

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