Complications and Management of Totally Implantable Central Venous Access Ports in Cancer Patients at a University Hospital in Oman

Abstract

Objectives: Totally implantable central venous access ports (port-a-caths) are increasingly used for the safe administration of chemotherapy; however, their use is associated with complications. This study reviews patterns of complications, reasons for premature removal and the duration of the use of port-a-caths in patients receiving cancer treatment at Sultan Qaboos University Hospital (SQUH) and compares the infection rate with the literature and the researchers’ experiences. Methods: This retrospective follow-up study included patients who had received cancer treatment through a port-a-cath and were admitted to SQUH between January 2007 and April 2019. Demographic features, underlying diagnosis, clinical stage, treatment, duration of use and the cause of premature removal of the port-a-cath were recorded. Results: A total of 516 port-a-caths were inserted in 482 cancer patients. The majority of devices were implanted by interventional radiologists (n = 459; 89.0%) and the right internal jugular vein was most frequently accessed (n = 396; 76.7%). The mean indwelling time of a port-a-cath was 288 days (range: 3–1,872 days) for patients with complications and 550 days (range: 7–3,123 days) for patients without complications. Port-a-cath-related infection was the main complication (n = 63; 12.2%). Patient age, gender, treatment intent, underlying diagnosis, clinical stage, chemotherapy regimen, number of treatment courses, operator implanting the port, the type of micro-organism isolated from the port-a-cath and body mass index were significant factors affecting catheter indwelling time (P <0.05). On multivariate analysis, however, none of the factors was found to be significant. Conclusion: Infection was the most common complication necessitating port-a-cath removal. The infection rate was much lower than the researchers’ previous experience and compares favorably with several published reports. KEYWORDS Port-A-Cath; Vascular Access Ports; Catheter-Related Infections; Cancer; Oman.

Factors associated with unscheduled venous access port removal in cancer patients

“…Complications of IVAP often result in removal, prolonged hospital stay, intensive care unit admission, and death (30). Infection is the most common complication associated with IVAP (31).…”

“…Infection is the most common complication associated with IVAP (31). In particular, IVAP infection has a high morbidity rate and can result in early removal of IVAP (30). In addition, infections increase the length of hospital stay, morbidity, mortality, longterm antibiotic use, and costs (31,32).…”

Onkolojik Hastalarda İnternal Jügüler Ven Yoluyla Venöz Port Implantasyonu- Tek Bir Genel Cerrahın Deneyimi

“…Prospective studies are necessary to determine the superiority of one technique or venous insertion site over another definitively. Although many studies in the literature have demonstrated the safety of chemotherapy ports, the majority of these procedures have been performed by interventional radiologists (26,2). Recent studies have indicated a shift in the healthcare landscape even for the non-tunneled vascular catheters.…”

Implants for different types of cancer: an updated review

“…Over 50% of the patients underwent a single round of chemotherapy, with the remaining individuals opting for multiple lines of treatment delivered through the same port-a-cath. Notably, two patients abstained from receiving any cytotoxic chemotherapy [20]. For Skin A light-responsive, swiftly detachable microneedle (MN) patch designed to expediently transport drugloaded MNs to the skin, enabling recurrent administration of chemotherapy and photothermal therapy to superficial tumors through light activation.…”

“…The MNs, composed of a PCL polymer containing photosensitive nanomaterials LaB6 (lanthanum hexaboride) serving as photothermal transducers and the anticancer drug doxorubicin (DOX), were employed for cancer treatment. [20] Techniques [14] • Three-Dimensional Printing (3D Printing) Three-dimensional (3D) printing, an additive manufacturing (AM) technique pioneered at the Massachusetts Institute of Technology in the 1990s, involves converting Computer-Aided Design (CAD) into a Stereo Lithography (STL) file. This STL file is then utilized by the 3D printer to manage material movement and deposition.…”