title: Insertion of totally implantable central venous access devices by surgeons.
abstract: OBJECTIVE
  The aim of this study is to evaluate the results for the insertion of totally implantable central venous access devices (TICVADs) by surgeons.
  
  
  METHODS
  Total 397 patients, in whom TICVADs had been inserted for intravenous chemotherapy between September 2008 and June 2014, were pooled. This procedure was performed under local anesthesia in an operation room. The insertion site for the TICVAD was mainly in the right-side subclavian vein. In the case of breast cancer patients, the subclavian vein opposite the surgical site was used for insertion.
  
  
  RESULTS
  The 397 patients included 73 males and 324 females. Primary malignant tumors were mainly colorectal and breast cancer. The mean operation time was 54 minutes (18-276 minutes). Operation-related complications occurred in 33 cases (8.3%). Early complications developed in 15 cases with catheter malposition and puncture failure. Late complications, which developed after 24 hours, included inflammation in 6 cases, skin necrosis in 6 cases, hematoma in 3 cases, port malfunction in 1 case, port migration in 1 case, and intractable pain at the port site in 1 case.
  
  
  CONCLUSIONS
  Insertion of a TICVAD under local anesthesia by a surgeon is a relatively safe procedure. Meticulous undermining of the skin and carefully managing the TICVAD could minimize complications.
authors.affiliation: Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Hyeonjun
authors.initials: H
authors.lastname: An
authors.affiliation: Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Chun-Geun
authors.initials: CG
authors.lastname: Ryu
authors.affiliation: Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Eun-Joo
authors.initials: EJ
authors.lastname: Jung
authors.affiliation: Department of Surgery, Breast Cancer Center, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Paik
authors.affiliation: Department of Surgery, Breast Cancer Center, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Yang
authors.affiliation: Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Dae-Yong
authors.initials: DY
authors.lastname: Hwang
keywords: Central venous catheterization; Maintenance chemotherapy; Vascular access devices