Totally implantable ports connected to valved catheters for chemotherapy: experience from 350 Groshong devices.
OBJECTIVE
There are few studies regarding the use of totally implantable valved ports for chemotherapy. The objective of this study was to analyze the results obtained from consecutive implantation of 350 devices.


METHODS
Adult patients submitted to port insertion in veins of the superior vena cava system over a 17-month period (July 2006 to December 2007) were considered. The device used was composed of a titanium and silicone rubber port (Dome Port; Bard Inc, Salt Lake City, UT) connected to an 8.0 Fr silastic Groshong catheter tube. Follow-up was conducted on outpatient data and during clinical readmissions, until the device was removed or the patient died.


RESULTS
Three hundred and fifty devices, total of 74,691 days in situ, were inserted, with a median follow-up of 176 days. There were 11 early complications (3.1%) and 49 late complications (14%), 21 of these (6%) were considered major ones. Early complications comprised four instances of phlebitis of the external jugular, three of pocket infection, two of technical failure and two of ecchymosis. Late complications comprised 33 instances of withdrawal difficulty, 12 of port-related bacteremia, two of deep venous thrombosis, one of occlusion and one of catheter fracture. Out of the 350 catheters implanted, 258 (73.5%) were still being used, 73 (21%) remained in use until the patient died, five (1.5%) were removed at the end of the treatment and 14 (4%) were removed because of complications.


CONCLUSIONS
There was a low rate of major complications associated with this valved system justifying its use.
Nishinari
Kenji
K
Department of Vascular Surgery, Hospital A.C. Camargo, São Paulo, Brazil. marken@uol.com.br
Wolosker
Nelson
N
Bernardi
Christiano Vinicius
CV
Yazbek
Guilherme
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D055499:Catheter-Related Infections / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects; D020878:Device Removal; D004129:Dimethylpolysiloxanes; D004438:Ecchymosis / Q000209:etiology; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010689:Phlebitis / Q000209:etiology; D011475:Prosthesis Failure; D018570:Risk Assessment; D012826:Silicone Elastomers; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D014683:Vena Cava, Superior; D020246:Venous Thrombosis / Q000209:etiology; D055815:Young Adult
D000970:Antineoplastic Agents; D004129:Dimethylpolysiloxanes; D012826:Silicone Elastomers; C013830:baysilon; D014025:Titanium