title: A safe and effective method to implant a totally implantable access port in patients with synchronous bilateral mastectomies: modified femoral vein approach.
abstract: BACKGROUND
  The purpose of this study was to develop a modified method to implant a totally implantable access port (TIAP) using the femoral vein approach.
  
  
  METHODS
  We designed a modified method using the femoral vein approach to implant a TIAP in patients with synchronous bilateral breast cancer requiring bilateral mastectomy and postoperative chemotherapy. TIAP implantation was performed with parenteral sedation and local anesthesia in the operating room. All patients were followed for at least 12 months and the complications of TIAP were recorded.
  
  
  RESULTS
  In this retrospective study, 86 patients received the TIAP using the modified femoral vein approach. All patients had a history of bilateral breast cancer and underwent bilateral mastectomy. The early complication rate within the first 30 postoperative days was 2.3% and involved groin hematoma caused by missed puncture to the femoral artery during the operation. The late postoperative complication rates were 2.3% caused by local port infection, 1.2% by groin wound infection, and 3.5% by catheter occlusion. There were no complications associated with TIAP disconnection or systemic infection.
  
  
  CONCLUSIONS
  Traditional implantation of TIAP through the subclavian vein or cephalic vein is simple and is used worldwide. However, both the percutaneous puncture and cutdown methods have limitations and risks. We describe a safe and effective method using the modified femoral vein approach for specific patients.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Chen
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Lin
authors.forename: Hao-Ming
authors.initials: HM
authors.lastname: Chang
authors.forename: Huan-Ming
authors.initials: HM
authors.lastname: Hsu
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000601:surgery*; D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling; D005260:Female; D005268:Femoral Vein; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents