Almasi-Sperling V, Hieber S, Lermann J, Strahl O, Beckmann M W, Lang W, Sagban T A
Department of Vascular Surgery, Friedrich Alexander University Erlangen, Erlangen.
Department of Obstetrics and Gynecology, Friedrich Alexander University Erlangen, Erlangen.
Geburtshilfe Frauenheilkd. 2016 Jan;76(1):53-58. doi: 10.1055/s-0035-1558173.
Aim of this study was to determine the rate of complications following femoral placement of totally implantable venous access ports (f-TIVAP) in women with bilateral breast cancer, with a special focus on long-term function, deep vein thrombosis (DVT), and port infection. 73 patients with bilateral breast cancer treated between October 2000 and January 2013 with placement of an f-TIVAP using a transfemoral approach were retrospectively reviewed. All patients were followed up, and all complications of f-TIVAP were recorded. The median age was 62.5 years (range: 35-86 years). Four patients received f-TIVAP under local anesthesia, and 69 underwent placement under general anesthesia. Mean follow-up was 33.7 months (SD 25.9; range: 0.2-93.5 months). Complications over the entire period of observation included infections in 21 %, DVT in 19 % and catheter occlusion in 12 %. Patients receiving chemotherapy who developed leukopenia were more likely to experience DVT at the access site (p = 0.037). There was a trend towards a higher infection rate when the device was used more often (p = 0.084). Although the rates of complications in the longer term, especially device infections and DVTs, appeared to be relatively high, TIVAP implantation using femoral vein access is recommended in patients with bilateral breast cancer not suitable for cephalic vein cut-down.
本研究的目的是确定双侧乳腺癌女性患者经股静脉植入全植入式静脉通路端口(f-TIVAP)后的并发症发生率,特别关注其长期功能、深静脉血栓形成(DVT)和端口感染情况。对2000年10月至2013年1月期间采用经股动脉途径植入f-TIVAP治疗的73例双侧乳腺癌患者进行了回顾性研究。对所有患者进行随访,并记录f-TIVAP的所有并发症。中位年龄为62.5岁(范围:35 - 86岁)。4例患者在局部麻醉下接受f-TIVAP植入,69例在全身麻醉下进行植入。平均随访时间为33.7个月(标准差25.9;范围:0.2 - 93.5个月)。整个观察期内的并发症包括感染21%、DVT 19%和导管堵塞12%。接受化疗且发生白细胞减少的患者在穿刺部位发生DVT的可能性更高(p = 0.037)。使用该装置频率越高,感染率有升高趋势(p = 0.084)。虽然长期并发症发生率,尤其是装置感染和DVT,似乎相对较高,但对于不适合头静脉切开的双侧乳腺癌患者,建议采用股静脉途径植入TIVAP。