Wolosker N, Yazbek G, Munia M A, Zerati A E, Langer M, Nishinari K
Department of Vascular Surgery, Hospital do Câncer A.C. Camargo, São Paulo, Brazil.
Eur J Surg Oncol. 2004 Sep;30(7):771-5. doi: 10.1016/j.ejso.2004.05.019.
Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients. When it is impossible to implant the reservoir on the anterior wall of the thorax, or when there is an obstruction of the superior vena cava system, alternative access routes must be sought. Of these, the femoral vein is the most utilized. Few studies have been performed to analyse the results obtained from the implantation and utilization of such catheters in the femoral vein. The goal of this work was to prospectively study the results obtained from the implantation of 20 TIC in femoral veins in a large-sized cancer hospital with its own dedicated vascular clinical team.
Twenty femoral TIC were inserted in 20 patients out of a group of 560 cancer patients submitted to TIC implantation for chemotherapy. Evaluations were made of the early and late-stage complications and patient evolution until removal of the device, death or the end of the treatment.
The prospective analysis showed a mean duration of 215 days for the catheters. There were 16 patients with no complications. There were no early complications. Among the late complications, three were infections, representing 0.69/1000 days of catheter use, and one was a deep vein thrombosis (0.23/1000 days of catheter use). One catheter was removed due to primary bacteremia and one due to subcutaneous pocket infection. Fourteen patients died while the catheter was functioning and four patients are still making use of the catheter.
The low rate of complications implying catheter loss in this study confirms the safety and convenience of the use of femoral TIC in patients who cannot be submitted to implantation in the superior vena cava system.
完全植入式装置越来越多地用于肿瘤患者的化疗治疗。当无法将储液器植入胸壁前壁，或存在上腔静脉系统梗阻时，必须寻找替代的接入途径。其中，股静脉是最常用的。很少有研究分析通过股静脉植入和使用此类导管所获得的结果。本研究的目的是在一家拥有专门血管临床团队的大型癌症医院，对20例经股静脉植入全植入式中心静脉导管（TIC）的结果进行前瞻性研究。
在560例接受TIC植入化疗的癌症患者中，20例患者植入了股静脉TIC。对早期和晚期并发症以及患者直到装置取出、死亡或治疗结束的病情进展进行了评估。
前瞻性分析显示导管的平均使用时长为215天。16例患者无并发症。无早期并发症。晚期并发症中，3例为感染，导管使用天数的发生率为0.69/1000天，1例为深静脉血栓形成（导管使用天数的发生率为0.23/1000天）。1根导管因原发性菌血症取出，1根因皮下囊袋感染取出。14例患者在导管使用期间死亡，4例患者仍在使用导管。
本研究中并发症发生率低，未导致导管丢失，证实了对于无法进行上腔静脉系统植入的患者，使用股静脉TIC是安全且方便的。
