Görüntüleme eşliğinde takılan port kateterlerinin komplikasyonları ve komplikasyonlara etki eden faktörler

Year 2024, Volume: 17 Issue: 2, 303 - 312, 01.04.2024

Muhammed Tekinhatun , Muhammet Arslan , Halil Serdar Aslan , Hüseyin Gökhan Yavaş , Mahmut Demirci , Başak Ünver Koluman , Kadirhan Alver

https://doi.org/10.31362/patd.1368908

Abstract

Amaç: Bu araştırma, Görüntüleme Destekli Port Kateterler (IAPC'ler) ile ilişkili komplikasyonları araştırarak, bunların kullanımında yer alan sağlık çalışanlarına öngörü sağlamaktadır. Çalışma, hasta güvenliğini optimize etmeyi, önleyici stratejiler uygulamayı ve IAPC'lerin klinik kullanımında kanıta dayalı karar verme sürecine rehberlik etmeyi amaçlamaktadır.
Gereç ve yöntem: Girişimsel Radyoloji Ünitesinde 01.09.2012-01.09.2020 tarihleri arasında IAPC yerleştirilen 1247 hastayı içeren retrospektif bir çalışma yapıldı. Port yerleştirme endikasyonları, komplikasyonlar, portun kalış süresi ve eksplantasyon nedenleri dahil olmak üzere veriler elektronik tıbbi kayıtlardan elde edildi. Cerrahi olarak implante edilen portlarla karşılaştırmalı analiz yapıldı ve görüntüleme kılavuzluğunda port implantasyonunun etkinliği ve güvenliği değerlendirildi.
Bulgular: Çalışmada ağırlıklı olarak sağ internal juguler ven yerleştirildi (%93,8). Portun 7 ila 1330 günlük kullanımı sırasında majör komplikasyon görülmedi. Ortalama kullanım süresi 243 gün ve toplam 310.503 kateter günü idi. En sık enfeksiyöz komplikasyonlar (%4,8) görülmüş olup hematolojik malignitelerde anlamlı derecede yüksektir (%13,9). Çok değişkenli analiz hematolojik malignite hastalarında komplikasyon oranının önemli ölçüde arttığını ortaya koymuştur (p<0,001).
Sonuç: Araştırma, IAPC kullanımında genel komplikasyon insidansının %8,6 olduğunu ve hematolojik malignitenin önemli bir bağımsız risk faktörü olarak tanımlandığını ortaya koymaktadır. Her 1000 kateter günü başına düşen düşük komplikasyon oranı (0,36), görüntü rehberliği ve prosedürel uzmanlığın faydalarını vurgulayan son çalışmalarla uyumludur. Özellikle hematolojik malignite hastalarında görülen enfeksiyöz komplikasyonlar, uzun süreli intravenöz erişim için IAPC yönetimini iyileştirmeye yönelik daha fazla araştırma yapılması gerektiğinin altını çizmektedir. Bu çalışma, hastaların yararına IAPC yönetimini ilerletmek için devam eden çabaları vurgulayarak, bu alanda çalışan sağlık profesyonelleri için önemli bilgiler sunmaktadır.

Keywords

Kanser tedavisi, kateterizasyon, komplikasyon, tamamen implante edilebilir port kateter, ultrason rehberliği

Complications of imaging-assisted port catheters and factors affecting complications

Abstract

Purpose: This research investigates complications associated with Imaging-Assisted Port Catheters (IAPCs) to provide insights for healthcare professionals involved in their usage. The study aims to optimize patient safety, implement preventive strategies, and guide evidence-based decision-making in the clinical use of IAPCs.
Materials and methods: A retrospective study comprising 1247 patients who underwent IAPC placement in the Interventional Radiology Unit between 01.09.2012-01.09.2020 was conducted. Data, including indications for port placement, complications, duration of port stay, and reasons for explantation, were extracted from electronic medical records. Comparative analysis with surgically implanted ports was performed, and the efficacy and safety of imaging-guided port implantation were assessed.
Results: The study predominantly involved right internal jugular vein placement (93.8%). Major complications did not occur during the 7 to 1330 days of port usage. The average usage period was 243 days, totaling 310,503 catheter-days. Infectious complications were the most common (4.8%), significantly higher (13.9%) in hematological malignancies. Multivariate analysis revealed a significantly increased complication rate in hematological malignancy patients (p<0.001).
Conclusion: The research reveals an 8.6% overall incidence of complications in IAPC usage, with hematologic malignancy identified as a significant independent risk factor. The low complication rate per 1000 catheter days (0.36) aligns with recent studies, emphasizing the benefits of image guidance and procedural expertise. Notably, infectious complications, especially in hematologic malignancy patients, underscore the need for further research to refine IAPC management for long-term intravenous access. The study contributes essential insights for healthcare professionals involved in the field, emphasizing ongoing efforts in advancing IAPC management for the benefit of patients.

Keywords

Cancer treatment, catheterization, complication, totally implantable access port, ultrasound guidance

Ethical Statement

Ethics committee approval: Ethics Committee approval from Pamukkale University Medical Ethics Committee (10.12.2020/60116787-020/73335)) were obtained.

Supporting Institution

none

Thanks

none

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