[Totally implantable central venous access devices in patients with cancer. Experience at a private oncology center].
BACKGROUND
Use of totally implantable central venous access ports in cancer patients is a common practice for chemotherapy not excluding early and late morbidity.


OBJECTIVE
To report the experience using these devices in a private cancer center.


METHODS
A consecutive series of 156 cases of patients using these devices placed by the same surgical team to enhance chemotherapy. They were evaluated over a period of 44 months. Prevalence of early and late complications and days-risk for patient infection was determined.


RESULTS
In 140 cases (89.8%) patients underwent placement of totally implantable devices by surgical cut down through the external jugular vein. One case was done (0.6%) through the internal jugular, and another one (0.6%) through the cephalic vein (0.6%). In the remaining 13 cases (8.4%) devices were placed by percutaneous puncture of the subclavian vein. In one case it was impossible to place it by any of the two access ways (0.6%). The prevalence of early complications was 3.22% and of late complications 1.93%. The average days-risk for the development of infection was 473.8/patient. One case had fracture of the catheter during follow up. There was no mortality.


CONCLUSIONS
Overall complication rate was 5.15%, similar to that reported by reference centers, without infection during follow-up. Access through the external jugular vein facilitates correct positioning of the catheter and has fewer complications.


CONCLUSIONS
The combination of a trained surgical team and careful monitoring reduces morbidity and prevents infections. Access through the external jugular is recommended for its accessibility and low morbidity.
Oncología Privada Integral ONKOS, Guadalajara, Jalisco, México. avygail5@yahoo.com.mx
Ana Olivia
AO
Cortés-Flores
Gilberto
G
Morgan-Villela
Ernesto Alejandro
EA
Juárez-Uzeta
Clotilde
C
Fuentes-Orozco
Jorge
J
Jiménez-Tornero
Alejandro
A
González-Ojeda
D000293:Adolescent; D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002173:Cancer Care Facilities; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D013350:Subclavian Vein; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
D000970:Antineoplastic Agents