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成年癌症患者立即使用完全植入式静脉输液港的安全性:一项回顾性单中心研究。

Safety of immediate use of totally implantable venous access ports in adult patients with cancer: a retrospective single-center study.

作者信息

Lee Jisu, Hur Sung Mo, Kim Zisun, Lim Cheol Wan

机构信息

Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

出版信息

Korean J Clin Oncol. 2021 Dec;17(2):104-110. doi: 10.14216/kjco.21016. Epub 2021 Dec 31.

Abstract

PURPOSE

Totally implantable venous access ports (TIVAPs) can be used long-term for safe administration of intravenous drugs. TIVAP complications include catheter-related infections, venous thrombosis, extravasation, TIVAP migration, and pain. The relationship between the timing of the first chemotherapy administration after port implantation and complications is controversial. This study aimed to investigate the safety of immediate use of TIVAPs and the associated risk factors for complications.

METHODS

Between January 2016 and December 2018, 305 patients (median age, 53 years; 256 women) who underwent TIVAP placement at our institution were included. Chemotherapy was administered within 2 days of implantation. A retrospective analysis of patients' clinical data was performed to investigate catheter days and complications of TIVAPs.

RESULTS

Overall, 305 patients were evaluated over 57,324 catheter days (median, 168 catheter days; interquartile range, 105). The median interval between placement and first use of TIVAPs was 0.98 days. The overall morbidity rate was 2.95%. Nine complications occurred in nine patients, including TIVAP-related infection (4), pain (2), port occlusion (1), thrombosis (1), and scar disunion (1), of which five required port removal (1.64%). The median number of catheter days before complications occurred was 61 (range, 10-457 days; interquartile range, 51). No complications occurred within 7 days of implantation. Body mass index was an independent risk factor for TIVAP-related complications in the Cox proportional hazards model (multivariable analysis: hazard ratio, 1.221; 95% confidence interval, 1.054-1.414; P=0.008).

CONCLUSION

This study suggests the safe long-term use of TIVAPs following their immediate chemotherapy administration within 2 days of implantation.

摘要

目的

完全植入式静脉输液港(TIVAPs)可长期用于安全地静脉给药。TIVAP的并发症包括导管相关感染、静脉血栓形成、外渗、TIVAP移位和疼痛。输液港植入后首次化疗给药时间与并发症之间的关系存在争议。本研究旨在调查TIVAP立即使用的安全性以及并发症的相关危险因素。

方法

纳入2016年1月至2018年12月期间在本机构接受TIVAP植入的305例患者(中位年龄53岁;女性256例)。在植入后2天内进行化疗。对患者的临床资料进行回顾性分析,以调查TIVAP的置管天数和并发症情况。

结果

总体而言,305例患者在57324个导管日期间接受了评估(中位值,168个导管日;四分位间距,105)。TIVAP植入与首次使用之间的中位间隔时间为0.98天。总体发病率为2.95%。9例患者出现了9种并发症,包括TIVAP相关感染(4例)、疼痛(2例)、端口阻塞(1例)、血栓形成(1例)和瘢痕裂开(1例),其中5例需要拔除输液港(1.64%)。并发症发生前的中位导管天数为61天(范围,10 - 457天;四分位间距,51)。植入后7天内未发生并发症。在Cox比例风险模型中,体重指数是TIVAP相关并发症的独立危险因素(多变量分析:风险比,1.221;95%置信区间,1.054 - 1.414;P = 0.008)。

结论

本研究表明,在植入后2天内立即进行化疗后,TIVAP可安全长期使用。

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