title: Reasons for explantation of totally implantable access ports: a multivariate analysis of 385 consecutive patients.
abstract: BACKGROUND
  The objective of this study was to analyze factors leading to explantation of totally implanted access ports (TIAPs) and to assess its occurrence and clinical relevance.
  
  
  METHODS
  Of 438 patient consecutive patients with a port explantation, 385 were eligible for this retrospective cohort study. Reasons for explantation as well as demographic, clinical, and surgical characteristics were analyzed by univariate and multivariate models.
  
  
  RESULTS
  The diagnoses leading to TIAP implantation were hematological malignancies in 142 patients (36.8%), breast cancer in 103 patients (26.8%), gastrointestinal cancer in 76 patients (19.8%), nonmalignant diseases in 46 patients (11.9%), and other malignant diseases in 18 patients (4.7%). The reasons for TIAP explantation were infection in 178 patients (46.2%), end of treatment in 129 patients (33.5%), thrombosis in 44 patients (11.4%), TIAP dysfunction in 22 patients (5.7%), and other reasons in 12 patients (3.2%). At the time of TIAP explantation, 115 patients (29.9%) were receiving chemotherapy, and 49 patients (12.7%) were considered immunocompromised. In case of TIAP explantation due to infection, the median length of TIAP in situ time was 303.3 days, whereas the cumulative 10-day and 30-day explantation rates were 2.8% and 10.6%, respectively. By multivariate models, TIAP explantation due to infection is statistically significantly decreased in patients with breast cancer (P < .01) but significantly increased in patients with recurrent TIAP implantation and with ongoing chemotherapy (P < .01).
  
  
  CONCLUSIONS
  TIAP explantations are caused primarily by late-term complications, mainly infections. The subsequent interruption of ongoing treatment makes further efforts necessary to reduce such complications.
authors.affiliation: Department of General, Visceral and Trauma Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany. lars.fischer@med.uni-heidelberg.de
authors.forename: Lars
authors.initials: L
authors.lastname: Fischer
authors.forename: Phillip
authors.initials: P
authors.lastname: Knebel
authors.forename: Steffen
authors.initials: S
authors.lastname: Schröder
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Markus K
authors.initials: MK
authors.lastname: Diener
authors.forename: Roland
authors.initials: R
authors.lastname: Hennes
authors.forename: Klaus
authors.initials: K
authors.lastname: Buhl
authors.forename: Bruno
authors.initials: B
authors.lastname: Schmied
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Seiler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000009:adverse effects*; D015331:Cohort Studies; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology / Q000628:therapy