Totally implanted device for long-term intravenous chemotherapy: experience in 123 adult patients with solid neoplasms.
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.
Puig-la Calle
J
J
Department of General and Digestive Surgery, Hospital de la Santa Cruz Y San Pablo, Barcelona, Spain.
López Sánchez
S
S
Piedrafita Serra
E
E
Allende Honorato
L
L
Artigas Raventós
V
V
Puig la Calle
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*
D000970:Antineoplastic Agents