title: [Long-term central venous access in oncology. Review of a caseload of 750 cases].
abstract: Totally implantable central venous accesses systems are presently widely used in cancer patients. Perioperative and long-term morbidity of 750 consecutive implants performed from 1985 to 1994 were retrospectively reviewed. Our Series consisted in 616 (82.1%). Ports and 134 (17.9%) external tunnelled catheters with subcutaneous Dacron cuff (Hickmann or similar catheters) implanted by percutaneous access route in local anesthesia. Subclavian vein was the elective access route in 700 (93.3%) patients while in the remaining 50 (6.7%) the access was performed in the femoral vein, due to peculiar clinical conditions. One-day surgery was only required for 19 (2.6%) patients while outpatient surgery was the routine in 731 (97.4%) patients. Perioperative morbidity was at all similar both for Port and external catheters Series (p > 0.07). Late morbidity requiring the removal of the device occurred in 27/134 patients (18.7%) and in 40/616 (6.5%) for external catheters and Port Series, respectively (p < 0.002). The rate of infection, 2.3% for ports (p < 0.002). Patient's compliance was higher for Ports compared to external catheters. Apart from peculiar clinical conditions such as hematologic cancers, bone marrow transplantation or short life expectancy, Ports seem to guarantee for a lower morbidity coupled with better long-term results.
authors.affiliation: Istituto di Oncologia Clinica e Sperimentale, Università degli Studi, Genova.
authors.forename: S
authors.initials: S
authors.lastname: Bertoglio
authors.forename: P
authors.initials: P
authors.lastname: Meszsaros
authors.forename: C
authors.initials: C
authors.lastname: Disomma
authors.forename: L
authors.initials: L
authors.lastname: Moresco
authors.forename: F
authors.initials: F
authors.lastname: Cafiero
authors.forename: M
authors.initials: M
authors.lastname: Gipponi
authors.forename: P
authors.initials: P
authors.lastname: Percivale
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D013997:Time Factors