Puig-la Calle J, López Sánchez S, Piedrafita Serra E, Allende Honorato L, Artigas Raventós V, Puig la Calle J
Department of General and Digestive Surgery, Hospital de la Santa Cruz Y San Pablo, Barcelona, Spain.
J Surg Oncol. 1996 Aug;62(4):273-8. doi: 10.1002/(SICI)1096-9098(199608)62:4<273::AID-JSO9>3.0.CO;2-3.
Vascular access in patients receiving prolonged chemotherapy is a difficult problem. This led to the introduction of a totally implanted device. We intend to assess the efficacy of this device in a subset of oncologic patients. Between May 1989 and November 1992, 129 devices were placed in 123 adult patients with solid neoplasms. Most of the catheters were inserted by cut-down of the external jugular vein. Follow-up period ranged from 28 to 70 months. Early complications occurred in 4 of 129 implants, all in percutaneously inserted catheters. Infection was the most frequent late complication. By March 1995, 113 devices had been removed, 15 (13.3%) because of complications. Mean life of the explanted systems was 512 days. Totally implanted devices provide safe and efficient long-term venous access. Implantation should be performed by experienced surgeons, by cut-down whenever possible. Infection is the most serious complication and may be prevented by careful management.
接受长期化疗患者的血管通路是个难题。这促使了全植入式装置的引入。我们打算评估该装置在一部分肿瘤患者中的疗效。1989年5月至1992年11月期间，123例成年实体瘤患者植入了129个装置。大多数导管通过切开颈外静脉插入。随访期为28至70个月。129个植入装置中有4个发生早期并发症，均为经皮插入的导管。感染是最常见的晚期并发症。到1995年3月，113个装置已被取出，15个（13.3%）因并发症取出。取出系统的平均使用时间为512天。全植入式装置提供安全有效的长期静脉通路。植入应由经验丰富的外科医生进行，尽可能通过切开的方式。感染是最严重的并发症，通过仔细管理可预防。
