Chest port placement with use of the single-incision insertion technique.
OBJECTIVE
To evaluate the single-incision technique for the placement of subcutaneous chest ports. Advantages, technical success, and complications were assessed.


METHODS
From March 2007 through May 2008, 161 consecutive chest ports were placed with a modified single-incision technique and sonographic and fluoroscopic guidance via the right internal jugular vein (IJV; n = 130), right external jugular vein (n = 1), right subclavian vein (n = 1), or left IJV (n = 28). The primary indication was for long-term chemotherapy; all patients had malignancy.


RESULTS
All single-incision chest port insertions were technically successful. Ports were placed in patients 19 months to 93 years of age (mean, 56.3 y), with a mean follow-up of 203.6 device-days per patient and a total of 32,779 catheter access days. No procedure-related complications, pocket hematomas, venous thromboses, or pneumothoraces were observed. Minor delayed complications occurred in three patients. Premature catheter removal was required for two patients (1.2%; 0.006 per 100 catheter-days). One port was removed less than 30 days after implantation for infection of the pocket (0.61%; 0.003 per 100 catheter-days). Another catheter was removed because of patient dissatisfaction and unconfirmed concerns with arrhythmia (0.61%; 0.003 per 100 catheter-days). One minor superficial wound infection was successfully treated with oral antibiotics, with the port kept in place.


CONCLUSIONS
Use of a single-incision technique for chest port implantation in adult and pediatric oncology patients is feasible. This may be the preferred method of subcutaneous port placement, as it has a very low complication rate and a high success rate. Prospective evaluation is needed to compare it versus the conventional two-incision technique.
Charles
Hearns W
HW
Division of Vascular and Interventional Radiology, Department of Radiology, Tisch Hospital, New York University Langone Medical Center, HE-221, 560 First Avenue, New York, NY 10016, USA. hearns.charles@nyumc.org
Miguel
Tiago
T
Kovacs
Sandor
S
Gohari
Arash
A
Arampulikan
Joseph
J
McCann
Jeffrey W
JW
D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000379:methods*; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019919:Prosthesis Implantation / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult