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Totally implantable venous access port systems and risk factors for complications.
F.Narducci1, M. Jean-Laurent2, L. Boulanger1, S. El B_edoui1, Y. Mallet1, J.L. Houpeau1, A. Hamdani1, N. Penel1, C.Fournier1
1Oscar Lambret Regional Cancer Centre
2Mothers’ & Children’s Centre, Frot de France University Hospital
One year prospective cohort study in a cancer centre
Impantable ports (IP) emerged around 15 years ago and rapidly became an essential tool in the management of patients requiring repeated and/or long-term treatments. Peripheral administration of cytostatic agents in oncology in particular can cause irreversible damage to patients’ venous access and above all, serious local complications if the substances are extravasate. IP are therefore the commonest indication in this situation from the first chemotherapy administered. Our activity in this field in a cancer centre, such as the Oscar Lambret Centre, is considerable and is continuing to increase. Implantation of these systems is not without its side-effects or complications. Despite the improvement in materials and equipment, catheter-related infections, symptomatic venous thrombosis and catheter ruptures have been reported.
Aims: Our aims were to measure the complications associated with implantable ports (IP) during the year after implantation and analysing risk factors for each of the complications and to assess patient satisfaction with the implantation of an IP (particularly pain, scarring and anaesthetic discomfort) and the patient’s quality of life.
Materials and methods: This was a prospective observational descriptive study of practice in a cancer centre. The IP implanted were the POLYSITE® 3007 and 3008 ISP (Perouse Medical). Results: Ease of insertion: considered straight forward in 679 cases out of 760 (89% of cases); Use of the IP: the medium time between insertion and use was 8 days (mean 12.4 +/- 14.6j); Complications: No one died during the study. Complications were recorded in 131/815 patients, mostly infection, local haematomas or local skin problems; Risk factors: no influence from length of experience of surgeon or type of implant (3007 and 3008). Conclusion: the time interval between insertion and first use had a significant impact (p <0.001) on the complication rate and incidence of skin disorders and infection.
