title: Complications of venous access ports in 132 patients with disseminated testicular cancer treated with polychemotherapy.
abstract: OBJECTIVE
  Venous access ports (VAPs) can be used to administer polychemotherapy to patients with malignancies. The purpose of this study was to evaluate perioperative and late complications related to VAP implantations and to analyze factors that may predict the development of complications.
  
  
  METHODS
  During the period 1983 to 1994, 135 VAPs were implanted in 132 patients with disseminated testicular tumors. In a retrospective study, the perioperative and late complications were recorded in this homogeneous patient group. Multivariate analysis was performed to detect factors that may predict the development of complications.
  
  
  RESULTS
  The median age of the patients was 28 years (range, 16 to 55). Perioperative complications were recorded in five patients (3.7%): pneumothorax in two (1.5%), blood loss in two (1.5%), and mediastinal bleeding in one (0.7%). The ports remained in situ for a total of 55,247 days (median, 413; range, 7 to 1,607). In 31 patients (23%), 42 late complications developed (31%): system obstruction in 13 (9.6%), thrombosis in 11 (8.1%), infection in six (4.4%), catheter defect in six (4.4%), extravasation in four (3.0%), and local skin necrosis in two (1.5%). Late complications were significantly more common in patients who had received chemotherapy before VAP implantation (P < .001). Univariate analysis showed that there were significantly more complications after VAP implantation under local anesthesia than under general anesthesia (P < .05).
  
  
  CONCLUSIONS
  Polychemotherapy could be administered in an adequate manner using a VAP. Complications occurred in 26.7% of a homogeneous group of patients who received a VAP implantation for polychemotherapy for disseminated testicular cancer. Chemotherapy treatment before VAP implantation was the only independent risk factor for late complications.
authors.affiliation: Department of Surgical Oncology, University Hospital Groningen, The Netherlands.
authors.forename: N W
authors.initials: NW
authors.lastname: Lemmers
authors.forename: M E
authors.initials: ME
authors.lastname: Gels
authors.forename: D T
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: J T
authors.initials: JT
authors.lastname: Plukker
authors.forename: W T
authors.initials: WT
authors.lastname: van der Graaf
authors.forename: Z J
authors.initials: ZJ
authors.lastname: de Langen
authors.forename: J H
authors.initials: JH
authors.lastname: Droste
authors.forename: H S
authors.initials: HS
authors.lastname: Koops
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors