Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL 35223, USA.
Gynecol Oncol. 2011 Oct;123(1):54-7. doi: 10.1016/j.ygyno.2011.06.012. Epub 2011 Jul 13.
The purpose of this study was to investigate the incidence of mechanical complications associated with low-profile subcutaneous implantable venous access devices in gynecologic oncology patients.
Gynecologic oncology patients with low-profile Port-a-Caths implanted between March 2005 and July 2006 were identified into a computerized database. Patient demographics, operative complications, number of chemotherapy cycles, duration of implantation, and mechanical complications were collected. Primary outcomes included port leakage, catheter fracture, and catheter embolization.
112 patients underwent 115 Port-a-Cath placements with low profile single-lumen plastic ports with Groshong-valved catheters. Mean Port-a-Cath indwelling duration was 197 days (range: 4-395) with a mean number of 12 chemotherapy cycles (range 0-64). The cumulative complication rate necessitating removal or replacement was 15%. Of the 14 Port-a-Caths removed, ten (8.7%) were secondary to mechanical malfunction: one for leakage at the port site, two for catheter fracture, and seven for fracture with catheter embolization to the heart or pulmonary vasculature-most commonly the right ventricle. Patients with embolization were asymptomatic and all embolized catheters were successfully retrieved by interventional radiology without complications.
The rates of catheter fracture and embolization have previously been reported to be low in patients with subcutaneous Port-a-Caths, and have not been studied in patients receiving low-profile subcutaneous Port-a-Caths. This study suggests that catheter fracture may be more common (8.7%) and must be considered in patients with malfunctioning low-profile Port-a-Caths. Embolized catheters can be removed by interventional radiology without significant adverse affects.
本研究旨在探讨妇科肿瘤患者中使用低轮廓皮下植入式静脉通路装置相关机械并发症的发生率。
我们将 2005 年 3 月至 2006 年 7 月间接受低轮廓 Port-a-Cath 植入的妇科肿瘤患者纳入计算机数据库。收集患者的人口统计学数据、手术并发症、化疗周期数、植入时间和机械并发症等资料。主要结局包括端口渗漏、导管断裂和导管栓塞。
共有 112 例患者接受了 115 例低轮廓单腔塑料端口与 Groshong 瓣膜导管的 Port-a-Cath 植入术。Port-a-Cath 平均留置时间为 197 天（范围：4-395），平均化疗周期数为 12 个（范围 0-64）。需要移除或更换的总并发症发生率为 15%。在 14 个被移除的 Port-a-Cath 中，有 10 个（8.7%）是由于机械故障所致：1 个是由于端口处渗漏，2 个是由于导管断裂，7 个是由于导管断裂并栓塞至心脏或肺血管-最常见的是右心室。栓塞的患者无症状，所有栓塞的导管均通过介入放射学成功取出，无并发症。
以前已经报道过皮下 Port-a-Cath 患者中导管断裂和栓塞的发生率较低，而在接受低轮廓皮下 Port-a-Cath 的患者中尚未进行研究。本研究表明，导管断裂的发生率可能更高（8.7%），在低轮廓 Port-a-Cath 功能障碍的患者中应考虑这一问题。栓塞的导管可通过介入放射学取出，无明显不良影响。
