Shah Tanay, Vijay D G, Shah Niket, Patel Bhavesh, Patel Samir, Khant Nikhilsinh, Gothwal Kalyansing
HCG Cancer Hospital, Ahmedabad, India.
Indian J Surg Oncol. 2021 Mar;12(1):139-145. doi: 10.1007/s13193-020-01265-6. Epub 2021 Jan 7.
Implantable chemoport is a very useful device for long-term venous access for infusion of chemotherapeutic drugs and other agents. There are few studies from resource poor countries reporting complications of chemoport. The aim of the present study is to evaluate the feasibility of chemoport insertion without image guidance and by closed technique without direct visualisation of a major vein (mainly IJV) and to study the complications associated with the procedure. This was a prospective observational study which analysed 263 patients who underwent chemoport insertion. The medical records of these patients were analysed for the patient characteristics, diagnosis, port-related complications, and their management. A total of 263 patients who were harbouring either locoregionally advanced or metastatic tumour requiring either chemotherapy or targeted treatment or both were included in the study. In total, 133 (50.57%) were female patients and 130 were male patients (49.43%). A total of 236 patients (89.73%) underwent port insertion procedures under local anaesthesia. None of the patients had any major intra-operative complications. Postoperatively, 4 patients (1.52%) were found to have port catheter malposition; 3 out of this 4 were corrected under IITV guidance as a second procedure under local anaesthesia only. One patient (0.38%) required formal removal and replacement of port. Four patients (1.52%) developed IJV thrombosis requiring port removal and anti-coagulation. One patient (0.38%) developed thrombus in the right atrium. There were 2 port site infections (0.74%) requiring port removal (SSI cat. 5). Low complication rates of port insertion were observed in the present, large, prospective study. Complication rates may be further reduced by using a well-designed procedure, experienced surgeons, an aseptic environment, ultrasound-guided puncture, and fluoroscopy with contrast media.
The online version contains supplementary material available at 10.1007/s13193-020-01265-6.
植入式化疗端口是一种非常有用的装置，用于长期静脉通路以输注化疗药物和其他药剂。资源匮乏国家关于化疗端口并发症的研究很少。本研究的目的是评估在无影像引导下且通过闭合技术在未直接可视化主要静脉（主要是颈内静脉）的情况下插入化疗端口的可行性，并研究与该操作相关的并发症。这是一项前瞻性观察性研究，分析了263例行化疗端口插入术的患者。对这些患者的病历进行分析，以了解患者特征、诊断、端口相关并发症及其处理情况。共有263例患有局部晚期或转移性肿瘤且需要化疗或靶向治疗或两者皆需的患者纳入研究。其中，女性患者133例（50.57%），男性患者130例（49.43%）。共有236例患者（89.73%）在局部麻醉下进行了端口插入操作。所有患者术中均未出现任何重大并发症。术后，发现4例患者（1.52%）端口导管位置不当；这4例中的3例在仅局部麻醉下的第二次操作中在术中静脉造影引导下得到纠正。1例患者（0.38%）需要正式取出并更换端口。4例患者（1.52%）发生颈内静脉血栓形成，需要取出端口并进行抗凝治疗。1例患者（0.38%）右心房出现血栓。有2例端口部位感染（0.74%）需要取出端口（手术部位感染分类5级）。在本项大型前瞻性研究中观察到端口插入的并发症发生率较低。通过采用精心设计的操作、经验丰富的外科医生、无菌环境、超声引导穿刺以及使用造影剂的荧光透视检查，并发症发生率可能会进一步降低。
在线版本包含可在10.1007/s13193-020-01265-6获取的补充材料。
