OUTCOMES OF APPLICATIONS OF THE IMPLANTABLE VENOUS ACCESS PORT INSERTION IN OUR HOSPITAL THROUGH THE INTRAVENOUS ROUTE

Year 2020, Volume: 21 Issue: 4, 345 - 352, 14.10.2020

Fehim Can Sevil

https://doi.org/10.18229/kocatepetip.777754

Cited By: 1

Abstract

OBJECTIVE: In this study, the clinical features, periprocedural outcomes, early and late complications and treatment strategies in patients with an implantable venous access port were presented.
MATERIAL AND METHODS: A total of 187 venous access ports were implanted to 171 patients between 2013 and 2020 in our hospital. The demographic characteristics, primary cancer diagnoses, the success and duration of the technical procedure, early and late complications of the patients taken from their files were retrospectively analyzed.
RESULTS: Of the patients whose venous access ports were implanted, 100 (58.4%) were male and 71 (41.6%) were female, with an average age of 62.63 ± 12.37 years while the age distribution was 17-86 years. The most common type of cancer in patients was colon cancer, and it was detected in 88 (51.4%) of the patients. The second most commonly observed cancer was gastric cancer which was detected in 20 (11.6%) of the patients. The most frequently accessed vein was the right internal jugular vein preferred in the 103 (55.1%) of the patients’ cases. Early complications were observed in 21 (11.2%) of the applications. The most common early complication was malposition in ten (5.3%), while the secondly most common early complication was artery puncture in four (2.1%) applications. Late complications were observed in 25 (13.3%) of the applications. The most common late complication was the development of the infection due to the venous access port application and was seen in 11 (5.8%) of the applications. In nine of these patients, the infection was limited to the infection in the subcutaneous reservoir pocket, while in two patients an infection causing sepsis occurred. There was no mortality due to the venous access port application.
CONCLUSIONS: Our study showed that the application of a venous access port implanted with high technical success and low complication rates with fluoroscopic imaging is safe and effective.

Keywords

Chemotherapy, Port catheter, Complication

HASTANEMİZDE İNTRAVENÖZ YOLLA YERLEŞTİRİLEN İMPLANTE EDİLEBİLİR VENÖZ ERİŞİM PORTU UYGULAMALARININ SONUÇLARI

Abstract

AMAÇ: Bu çalışmada venöz erişim portu implante edilen hastaların klinik özellikleri, cerrahi işlem sonuçları, erken ve geç dönem komplikasyonları ve tedavi stratejileri sunuldu.
GEREÇ VE YÖNTEM: Hastanemizde 2013-2020 yılları arasında 171 hastaya toplam 187 venöz erişim portu implante edildi. Hastaların demografik özellikleri, primer kanser tanıları, teknik işlemin başarısı ve süresi, erken ve geç dönem komplikasyonları hasta dosyalarından retrospektif olarak incelendi.
BULGULAR: Venöz erişim portu implante edilen hastaların 100’ü (58.4%) erkek, 71’i (41.6%) kadın olup yaş ortalaması 62.63±12.37 yıl; yaş dağılımı ise 17-86 yıl idi. Hastalarda en sık görülen kanser türü kolon kanseri olup hastalardan 88’ inde (51.4%) saptandı. İkinci en sık izlenen kanser hastalardan 20’sinde (11.6%) görülen mide kanseri idi. En sık erişim sağlanan ven hastalardan 103’ünde (55.1%) tercih edilen sağ internal jugular ven idi. Erken dönem komplikasyonlar uygulamalardan 21’inde (11.2%) izlendi. En sık erken dönem komplikasyon girişimlerden on tanesinde (5.3%) görülen malpozisyon iken sonraki en sık erken dönem komplikasyon ise uygulamalardan dördünde (2.1%) görülen arter ponksiyonu idi. Geç dönem komplikasyonlar uygulamalardan 25’inde (13.3%) izlendi. En sık geç dönem komplikasyonu venöz erişim portu uygulanmasına bağlı enfeksiyon gelişmesi idi ve uygulamalardan 11’inde(5.8%) görüldü. Bu hastalardan dokuzunda enfeksiyon cilt altı rezervuar cebin enfeksiyonu ile sınırlı iken iki hastada sepsise neden olan enfeksiyon oluştu. Venöz erişim portu uygulamasına bağlı mortalite görülmedi.
SONUÇ: Çalışmamız yüksek teknik başarı ve anjiyografik görüntüleme eşliğinde düşük komplikasyon oranları ile implante edilen venöz erişim portu uygulamasının güvenli ve etkin olduğunu göstermiştir.

Keywords

kemoterapi, venöz erişim, perkütan girişim, komplikasyon, port kateter

References

• Referans1. Velioğlu Y, Yüksel A, Sinmaz E. Complications and management strategies of totally implantable venous access port insertion through percutaneous subclavian vein. Turkish J Thorac Cardiovasc Surg. 2019; 27(4): 499–507.
• Referans2. Bayrak S. Port catheter implantation under scopy in hybrid operation rooms. Turkish J Thorac Cardiovasc Surg. 2012; 20(2):275-280.
• Referans3. Woller SC, Stevens SM, Evans RS. The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) initiative: A summary and review of peripherally inserted central catheter and venous catheter appropriate use. Journal of Hospital Medicine. 2016; 11(4):306-10.
• Referans4. Cheung E, Baerlocher MO, Asch M, Myers A. Venous access: A practical review for 2009. Can Fam Physician. 2009; 55(5):494-6.
• Referans5. Lingegowda D, Gehani A, Sen S, Mukhopadhyay S, Ghosh P. Centrally inserted tunnelled peripherally inserted central catheter: Off-label use for venous access in oncology patients [published online ahead of print, 2020 Mar 5]. J Vasc Access. 2020;1129729820909028. doi:10.1177/1129729820909028
• Referans6. Kreidieh FY, Moukadem HA, El Saghir NS. Overview, prevention and management of chemotherapy extravasation. World Journal of Clinical Oncology. 2016; 10;7(1):87-97.
• Referans7. Tabatabaie O, Kasumova GG, Eskander MF,et al. Totally implantable venous access devices: A review of complications and management strategies. American Journal of Clinical Oncology: Cancer Clinical Trials. 2017; 40 (1): 94
• Referans8. Sevil FC, Tort M, Yıldız Z, et al. Successful percutaneous removal of retained J-tip guidewire: A report of two cases. Turk J Vasc Surg 2020;29(1):66-69.
• Referans9. Yildizeli B, Laçin T, Batirel HF, Yüksel M. Complications and management of long-term central venous access catheters and ports. Journal of Vascular Access. 2004; 5(4), 174–178.
• Referans10. Narducci F, Jean-Laurent M, Boulanger L, et al. Totally implantable venous access port systems and risk factors for complications: A one-year prospective study in a cancer centre. Eur J Surg Oncol. 2011; 37(10):913-8.
• Referans11. Seok JP, Kim YJ, Cho HM, et al. A retrospective clinical study: Complications of totally implanted central venous access ports. Korean J Thorac Cardiovasc Surg. 2014; 47(1):26-31
• Referans12. Yanik F, Karamustafaoğlu YA, Karataş A, Yörük Y. Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years. Turkish J Thorac Cardiovasc Surg. 2018; 26(3):422-428.
• Referans13. El-Balat A, Schmeil I, Karn T, et al. Catheter-related complications of subcutaneous implantable venous access devices in breast cancer patients. In Vivo (Brooklyn). 2018; 32(5): 1275–1281.
• Referans14. Zaghal A, Khalife M, Mukherji D, et al. Update on totally implantable venous access devices. Surgical Oncology. 2012; 21(3):207-15.
• Referans15. Randolph AG, Cook DJ, Gonzales CA, Pribble CG. Ultrasound guidance for placement of central venous catheters: A meta- analysis of the literature. Crit Care Med. 1996; 24(12):2053-8.
• Referans16. Gebauer B, El-Sheik M, Vogt M, Wagner HJ. Combined ultrasound and fluoroscopy guided port catheter implantation-High success and low complication rate. Eur J Radiol. 2009; 69(3):517-22.
• Referans17. Di Carlo I, Pulvirenti E, Mannino M, Toro A. Increased use of percutaneous technique for totally implantable venous access devices. Is it real progress? A 27-year comprehensive review on early complications. Ann Surg Oncol. 2010; 17(6):1649-56.
• Referans18. Dumanlı A. Journal KM. Künt Toraks Travması Geçiren Hastalarda Oluşan Akciğer Kontüzyonu İle Hemotoraks / Pnömotoraks Arasındaki İlişki The Relatıonshıp Between Hemothorax / Pneumothorax And Pulmonary Contusıon In Patıents Wıth Blunt Thoracıc Trauma Afyonkarahisar. 2020;217–21.
• Referans19. Orci LA, Meier RPH, Morel P, Staszewicz W, Toso C. Systematic review and meta-analysis of percutaneous subclavian vein puncture versus surgical venous cutdown for the insertion of a totally implantable venous access device. British Journal of Surgery. 2014; 101(2):8-16.
• Referans20. Pinelli F, Cecero E, Degl’Innocenti D, et al. Infection of totally implantable venous access devices: A review of the literature. Journal of Vascular Access. 2018; 19(3):230-242.
• Referans21. Vidal M, Genillon JP, Forestier E, et al. Outcome of totally implantable venous-access port-related infections. Médecine Mal Infect. 2016; 46(1):32-8.
• Referans22. Kurul S, Saip P, Aydin T. Totally implantable venous-access ports: Local problems and extravasation injury. Lancet Oncology. 2002; 3(11):684-92.