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右侧胸部端口与左侧胸部端口在有右侧端口移除史的肿瘤患者中的应用:并发症发生率是否存在差异?

Right- versus Left-Sided Chest Ports in Oncologic Patients with a History of Right-Sided Port Removal: Are There Any Differences in the Complication Rates?

机构信息

Department of Radiology, Division of Interventional Radiology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210.

Department of Radiology, Division of Interventional Radiology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210.

出版信息

J Vasc Interv Radiol. 2019 May;30(5):726-733. doi: 10.1016/j.jvir.2019.01.008. Epub 2019 Mar 27.

Abstract

PURPOSE

To compare chest port (port)-related complication rates between right- and left-sided ports placed in adult oncologic patients with a history of right-sided port removal.

MATERIALS AND METHODS

A retrospective chart review identified 90 adult oncologic patients with a history of right-sided port removal. Of these, 60 patients had a second port placed on the right side (right-side group), while 30 patients had a second port placed on the left side (left-side group). Median time between first port removal and second port placement was 217 days (range, 0-3808 days). Port-related complications included infection (port-site and/or bloodstream), mechanical, thrombotic, and port-site skin complications. Complication rates between groups were compared. Proportional subdistribution hazard regression (PSHREG) was conducted to determine if laterality of the second port is an independent risk factor for port-related complications.

RESULTS

The cumulative follow-up period was 34,748 catheter-days (median, 233; range, 9-2162 days). Eleven patients (18.3%) in the right-side group and 2 patients (6.7%) in the left-side group had port-related complications (P = .21), accounting for complication rates of 0.5 and 0.2/1000 catheter-days (P = .24), respectively. No statistical difference was found in the incidence of infection (9/60 vs 1/30, P = .16), mechanical (0/60 vs. 1/30, P = .33), thrombotic (1/60 vs 0/30, P = 1.0), and skin-related (1/60 vs 0/30, P = 1.0) complications between groups. In multivariate PSHREG, laterality of the second port (hazard ratio = 3.09, 95% confidence interval = 0.81-11.76, P = .10) was not a significant risk factor for port-related complications.

CONCLUSIONS

In adult oncologic patients with a history of right-sided port removal, no significant differences in port-related complication rates were observed between right- and left-sided second ports.

摘要

目的

比较有右侧中心静脉置管(PORT)取出史的成年肿瘤患者中,右侧和左侧 PORT 相关并发症的发生率。

材料与方法

回顾性图表审查确定了 90 例有右侧 PORT 取出史的成年肿瘤患者。其中,60 例患者在右侧放置了第二个 PORT(右侧组),而 30 例患者在左侧放置了第二个 PORT(左侧组)。第一次 PORT 取出和第二次 PORT 放置之间的中位时间为 217 天(范围,0-3808 天)。PORT 相关并发症包括感染(PORT 部位和/或血流)、机械性、血栓性和 PORT 部位皮肤并发症。比较两组的并发症发生率。采用比例亚分布风险回归(PSHREG)确定第二个 PORT 的侧别是否为 PORT 相关并发症的独立危险因素。

结果

累计随访时间为 34748 导管日(中位数,233;范围,9-2162 天)。右侧组中有 11 例(18.3%)和左侧组中有 2 例(6.7%)患者发生 PORT 相关并发症(P=.21),并发症发生率分别为 0.5 和 0.2/1000 导管日(P=.24)。两组感染(9/60 例比 1/30 例,P=.16)、机械性(0/60 例比 1/30 例,P=.33)、血栓性(1/60 例比 0/30 例,P=1.0)和皮肤相关(1/60 例比 0/30 例,P=1.0)并发症的发生率无统计学差异。多变量 PSHREG 分析中,第二个 PORT 的侧别(危险比=3.09,95%置信区间=0.81-11.76,P=.10)不是 PORT 相关并发症的显著危险因素。

结论

在有右侧 PORT 取出史的成年肿瘤患者中,右侧和左侧第二个 PORT 的 PORT 相关并发症发生率无显著差异。

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