Dave Samarth, Khunteta Nitin, Mohan Anand, Agarwal Deepesh, Das Mrinal, Viswanath Mohinder, Yadav Dinesh, Sharma Sanjay, Sharma Rajgovind
Dept. of Surgical Oncology, SRCC, Mahatma Gandhi Medical College and Hospital, MGUMST, Sitapura, Jaipur, Rajasthan India.
Dept. of Cardiology, SRCC, Mahatma Gandhi Medical College and Hospital, MGUMST, Sitapura, Jaipur, Rajasthan India.
Indian J Surg Oncol. 2024 Sep;15(3):590-593. doi: 10.1007/s13193-024-01949-3. Epub 2024 May 14.
Chemoport devices are commonly used for the administration of chemotherapeutic medication in cancer patients and can also be used for total parenteral nutrition and long term intravenous therapy. They are usually inserted through the internal jugular vein or the subclavian vein. The common complications of the procedure include pneumothorax, bleeding, arrhythmia and venous thrombosis. One of the rare complications of chemoport is catheter fracture/dislodgement and subsequent migration, with an incidence of 0.1-2.1%. Other rare complications are vascular erosion and embolization, vocal cord palsy and mediastinal hematoma. The aims and objectives are as follows: (1) to report a rare case of chemoport catheter migration between the right ventricle and pulmonary artery and (2) to review the literature on the rare complication of cardiac migration of a chemoport. A 56-year-old lady, known case of carcinoma right breast, post modified radical mastectomy was advised adjuvant chemotherapy. A chemoport catheter was placed in the right internal jugular vein and was positioned over the left upper chest. The 1st cycle of chemotherapy was given through chemoport and was uneventful. On the second chemotherapy schedule, catheter dysfunction was found. For the same, she was evaluated with chest radiography, which showed the migrated catheter in the heart. The migrated catheter was retrieved by snare technique using percutaneous transvenous route. The procedure was uneventful. The literature on the topic was reviewed. Chemoport catheter fracture or dislodgement and its subsequent cardiac migration are a rare but serious complication. High index of suspicion in case of catheter dysfunction, early detection by chest radiography, and timely multi-disciplinary intervention is crucial.
化疗端口装置常用于癌症患者化疗药物的给药，也可用于全胃肠外营养和长期静脉治疗。它们通常通过颈内静脉或锁骨下静脉插入。该操作的常见并发症包括气胸、出血、心律失常和静脉血栓形成。化疗端口罕见的并发症之一是导管断裂/移位及随后的迁移，发生率为0.1%-2.1%。其他罕见并发症有血管侵蚀和栓塞、声带麻痹及纵隔血肿。目的如下：（1）报告1例罕见的化疗端口导管在右心室和肺动脉之间迁移的病例；（2）回顾关于化疗端口心脏迁移这一罕见并发症的文献。一名56岁女性，已知右乳癌病例，改良根治性乳房切除术后接受辅助化疗。一根化疗端口导管置于右颈内静脉，并定位在左上胸部。第1周期化疗通过化疗端口进行，过程顺利。在第二次化疗方案时，发现导管功能障碍。为此，对她进行了胸部X线检查，显示导管迁移至心脏。通过经皮经静脉途径使用圈套技术取出迁移的导管。手术过程顺利。对该主题的文献进行了回顾。化疗端口导管断裂或移位及其随后的心脏迁移是一种罕见但严重的并发症。对导管功能障碍保持高度怀疑指数、通过胸部X线检查早期发现以及及时的多学科干预至关重要。
