Abstract
Purpose: This study aimed to evaluate the postoperative outcomes of central venous port implantation using the cephalic ‘cut-down’ technique.Methods: This study was conducted between March 2014 and March 2017. The study population consisted of patients who underwent venous port implantation using the cephalic ‘cut-down’ technique at the Department of Thoracic Surgery, Acibadem University, Atakent Hospital. Underlying pathology, operative technique and time, and perioperative complications were analyzed. Results: This study included 263 patients male = 137, female = 126, mean age = 51 years, range: 18-89 years . Of these, 250 patients underwent venous port implantation via the cephalic ‘cut-down’ technique success rate: 95% . In the remaining 13 patients, the procedure was completed percutaneously due to the small caliber of the vein or thrombophelebitis. The mean operative time of the 250 patients was 33 mi. range, 22-65 min . The most common primary disease was colon cancer 34% . None of the patients undergoing the cephalic ‘cut-down’ technique had any intraoperative complications. One patient undergoing the percutaneous technique had pneumothorax. During postoperative follow-up, three patients 1.4% underwent bleeding control procedure due to port-side bleeding.Conclusion: Venous port implantation using the cephalic ‘cut-down’ technique is a safe, feasible procedure with a low complication rate. The rarity of its potential life-threatening complications such as pneumothorax, hemothorax and great vessel injury is an important advantage of this procedure. Therefore, It has become a preferred procedure by patients as well as health care providers
References
- Özer AB, Bayar MK, İmplante Edilebilir Venöz Port Kateter Uygulamalarımızın İncelenmesi Fırat Tıp Dergisi 2011;16(1): 6-10
- Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet 1973; 136: 602-606.
- Hickman RO, Buckner CD, Clift RA, et al. A modified right atrial catheter for Access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 1979; 148: 871-875.
- Niederhuber JE, Ensminger W, Gyves JW, et al. Totally implanted venous and arterial access system to replace external catheter in cancer treatment. Surgery 1982; 92: 706-712.
- Povoski SP. A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients. Ann Surg Oncol 2000;7:496-502
- Eastridge BJ, Lefor AT. Complications of indwelling venous access devices in cancer patients. J Clin Oncol, 1995; 13: 233-238
- Groeger JS, Lucas AB, Thaler Hat, et al. Infectious morbidity associated with long term use of venous access devices in patients with cancer. Ann Intern Med, 1993; 119: 1168-74
- Samancı T, Molinas M N, Bozkurt A.K, et all. Evaluation of port complications in 115 cancer patients. Cerrahpaşa J Med 2004; 35: 71-77.
- D. Öcal, İ. Dolapçı, SVK Enfeksiyonları Türk Mikrobiyol Cem Derg 42(1):1-9, 2012
- Lokich JL, Bothe A, Benotti P,et al. Complications and management of implanted venous access catheters. J Clin Oncol, 1985; 3: 710-717
- Brincker H, Saeter G. Fifty-five patient years experience with a totally implanted system for intravenous chemotherapy. Cancer, 1986; 57: 1124-1129
- Behesti MV, Protzer WR, Tomlinson TL, et al. Long term results of radiologic placement of a central vein access device. Am J Radiol, 1998; 170: 731-734
- Kaufman JA, Salamipour H, Geller SC, et al. Long term outcome of radiologicaly placed arm ports. Radiology, 1996; 201: 725-730
- Bodner LJ, Nosher LJ, Patel KM, et al. Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol. 2000; 23: 187.
Abstract
Amaç: Bu çalışmada kliniğimzde sefalik ‘cut-down’ yöntemi kullanılarak yerleştirilen santral venöz port implantasyonunun cerrahi sonuçları değerlendirildi. Hastalar ve Yöntemler: Mart 2014 - Mart 2017 tarihleri arasında, Acıbadem Üniversitesi Tıp Fakültesi, Atakent Hastanesi, Göğüs Cerrahisi Servisi’nde sefalik ‘cut-down’ yöntemi ile venöz port implantasyonu uygulanan hastalar çalışmaya alındı. Altta yatan hastalıklar, ameliyat tekniği ve süresi ve perioperatif komplikasyonlar incelendi. Bulgular: Çalışmada toplam 263 hasta mevcuttu erkek = 137, kadın = 126, ortalama yaş = 51 yıl, dağılım = 18-89 yıl . Bu hastaların 250’ine sefalik ‘cut-down’ yöntemi ile venöz port takıldı başarı oranı: %95 . Sefalik ven kalibrasyonun yetersiz veya tromboflebitik olmasından dolayı diğer 13 hastada %5 işlem perkütan tamamlandı. 250 hastanın ortalama ameliyat süresi 33 dk dağılım; 22-65 dk idi. En sık altta yatan hastalık kolo-rektal kanserler idi. Sefalik ‘cut-down’ yöntemi ile venöz port takılan hastaların hiçbirinde ameliyat sırası komplikasyon izlenmedi. Perkütan yöntemle venöz port takılan bir hastada pnömotoraks gelişti. Tüp torakostomi gerekmedi. Postoperatif takipte 3 hastada %1.4 port yerinde kanama nedeniyle revizyon yapıldı. Sonuç: Sefalik ‘cut-down’ yöntemi ile venöz port takılması kolay uygulanabilen, güvenilir ve komplikasyon oranı düşük bir işlemdir. Pnömotoraks, hemotoraks veya büyük damar yaralanması gibi yaşamı tehdit eden potansiyel komplikasyonların nadir olması en önemli avantajıdır. Bu nedenle, hem hasta hem de sağlık çalışanları açısından kullanım kolaylığı nedeniyle tercih edilen bir işlemdir
References
- Özer AB, Bayar MK, İmplante Edilebilir Venöz Port Kateter Uygulamalarımızın İncelenmesi Fırat Tıp Dergisi 2011;16(1): 6-10
- Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet 1973; 136: 602-606.
- Hickman RO, Buckner CD, Clift RA, et al. A modified right atrial catheter for Access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 1979; 148: 871-875.
- Niederhuber JE, Ensminger W, Gyves JW, et al. Totally implanted venous and arterial access system to replace external catheter in cancer treatment. Surgery 1982; 92: 706-712.
- Povoski SP. A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients. Ann Surg Oncol 2000;7:496-502
- Eastridge BJ, Lefor AT. Complications of indwelling venous access devices in cancer patients. J Clin Oncol, 1995; 13: 233-238
- Groeger JS, Lucas AB, Thaler Hat, et al. Infectious morbidity associated with long term use of venous access devices in patients with cancer. Ann Intern Med, 1993; 119: 1168-74
- Samancı T, Molinas M N, Bozkurt A.K, et all. Evaluation of port complications in 115 cancer patients. Cerrahpaşa J Med 2004; 35: 71-77.
- D. Öcal, İ. Dolapçı, SVK Enfeksiyonları Türk Mikrobiyol Cem Derg 42(1):1-9, 2012
- Lokich JL, Bothe A, Benotti P,et al. Complications and management of implanted venous access catheters. J Clin Oncol, 1985; 3: 710-717
- Brincker H, Saeter G. Fifty-five patient years experience with a totally implanted system for intravenous chemotherapy. Cancer, 1986; 57: 1124-1129
- Behesti MV, Protzer WR, Tomlinson TL, et al. Long term results of radiologic placement of a central vein access device. Am J Radiol, 1998; 170: 731-734
- Kaufman JA, Salamipour H, Geller SC, et al. Long term outcome of radiologicaly placed arm ports. Radiology, 1996; 201: 725-730
- Bodner LJ, Nosher LJ, Patel KM, et al. Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol. 2000; 23: 187.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | June 1, 2017 |
| Published in Issue | Year 2017Issue: 2 |