A retrospective analysis on the utility and complications of upper arm ports in 433 cases at a single institute.
BACKGROUND
We have employed upper arm central venous ports (UACVPs) since 2006 for long-term intravenous chemotherapy (CTx) or fluid supplementation. We evaluated the long-term availability of CVPs implanted in the upper arm to determine whether UACVPs could be one of the treatment options besides chest CVPs in terms of CVP-related complications.


METHODS
We reviewed the medical records of all patients who underwent subcutaneous implantation of UACVPs at Kyoto University Hospital from 1 April, 2006 to 30 June, 2009. We assessed the indwelling duration of the UACVPs and the incidences of early and late UACVP-related complications.


RESULTS
A total of 433 patients underwent subcutaneous implantation of UACVPs during this time period. The cumulative follow-up period was 251,538 catheter days, and the median duration of UACVP indwelling was 439.0 days (1-2, 24). There was no UACVP-related mortality throughout the study period. A total of 83 UACVP-related complications occurred (19.2 %), including 43 cases of infection (9.9 %, 0.17/1000 catheter days), ten cases of catheter-related thrombosis (2.3 %, 0.040/1000 catheter days), ten cases of occlusion (2.3 %, 0.040/1000 catheter days), nine cases of catheter dislocation (2.0 %, 0.036/1000 catheter days), five cases of port leakage (1.2 %, 0.019/1000 catheter days), four cases of skin dehiscence (0.9 %, 0.015/1000 catheter days) and two cases of port chamber twist (0.5 %, 0.008/1000 catheter days). The removal-free one-year port availability was estimated at 87.8 %.


CONCLUSIONS
UACVPs were of long-term utility, with complication rates comparable to those of chest CVPs previously reported.
Department of Clinical Oncology, Kyoto University Hospital Cancer Center, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Yukiko
Y
Mori
Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. nagayama@kuhp.kyoto-u.ac.jp.
Satoshi
S
Nagayama
Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Jun-Ichiro
J
Kawamura
Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Suguru
S
Hasegawa
Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Eiji
E
Tanaka
Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Hiroshi
H
Okabe
Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Megumi
M
Takeuchi
Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto University, Yoshidahonmachi, Sakyo Ward, Kyoto, Kyoto, 606-8501, Japan.
Makoto
M
Sonobe
Department of Clinical Oncology, Kyoto University Hospital Cancer Center, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Shigemi
S
Matsumoto
Department of Clinical Oncology, Kyoto University Hospital Cancer Center, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Masashi
M
Kanai
Department of Clinical Oncology, Kyoto University Hospital Cancer Center, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Manabu
M
Muto
Department of Clinical Oncology, Kyoto University Hospital Cancer Center, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Gastroenterology and Hepatology, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Tsutomu
T
Chiba
Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Yoshiharu
Y
Sakai
D061605:Administration, Intravenous; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001132:Arm; D061807:Catheter Obstruction; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors
D000970:Antineoplastic Agents
CVP-related complications; Long-term availability; Upper arm central venous ports