[Total implantable venous systems in day surgery].
Total implantable venous system (port-cath)in day surgery.


OBJECTIVE
Most of patients underwent to a total implantable venous system (port-cath) can be treated in day surgery.


METHODS
Since January 2000 to March 2003 we have implanted 31 port-a-cath, preferring access in subclavia v. We've treated all patients in day surgery and we've performed a Rx-control with a medium follow up of two hour.


RESULTS
We have not reported any early complication, only 3 late complications: a device malfunction, a "kinking" reservoir and an infection of the subcutaneous pocket. The last two complications have required the explantation of the device. In difficult catheterizations can be helpful to use a pediatric kit. The rules of an aseptic and antiseptic operative procedure and the utilization of a short term antibiotic prophylaxis can avoid infective complications. We have proposed, after the device implantation, cardioaspirina like preventive therapy of septic and no septic thrombosis. In the thrombotic occlusion of the catheter we propose the use of activase. In malfunction's prevention we propose a lateral placement (to the skin incision) of the subcutaneous pocket and a 45 degrees reservoir rotation.


CONCLUSIONS
The total venous system (port-cath) implantation can be mostly performed in day surgery, improving the compliance of the patients with a low cost procedure.
Sperlongano
P
P
Dipartimento di Scienze Anestesiologiche, Chirurgiche e dell'Emergenza, V Divisione di Chirurgia Generale e Tecniche Chirurgiche Speciali, Seconda Università degli Studi di Napoli.
Piatto
A
A
De Falco
M
M
Parmeggiani
D
D
Pisaniello
D
D
Allocca
A
A
Vitolo
M
M
Parmeggiani
U
U
D000556:Ambulatory Surgical Procedures; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000209:etiology; D011292:Premedication; D012189:Retrospective Studies; D013350:Subclavian Vein; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D000925:Anticoagulants