Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan.
BACKGROUND
We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure.


METHODS
Questionnaire sheets concerning the number of implantation procedures and the incidence of complications for all procedures completed in 2012 were sent to 397 nationwide designated cancer care hospitals in Japan in June 2013. Venipuncture sites were categorized as chest, neck, upper arm, forearm, and others. Methods were categorized as landmark, cut-down, ultrasound-mark, real-time ultrasound guided, venography, and other groups.


RESULTS
We received 374 responses (11,693 procedures) from 153 centers (38.5 %). The overall complication rates were 7.4 % for the chest (598/8,097 cases); 6.8 % for the neck (157/2325); 5.2 % for the upper arm (54/1,033); 7.3 % for the forearm (9/124); and 6.1 % for the other groups (7/114). Compared to the chest group, only the upper arm group showed a significantly lower incidence of complications (P = 0.010), and multivariate logistic regression (odds ratio 0.69; 95 % confidence interval 0.51-0.91; P = 0.008) also showed similar findings. Real-time ultrasound-guided puncture was most commonly used in the upper arm group (83.8 %), followed by the neck (69.8 %), forearm (53.2 %), chest (41.8 %), and other groups (34.2 %).


CONCLUSIONS
Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.
Department of Medical Oncology, Tohoku University Hospital, Tohoku University, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574, Japan.|Department of Clinical Oncology, Institute of Development, Aging, and Cancer, Tohoku University, Seiryo-machi 4-1, Aoba-ku, Sendai, 980-8575, Japan.
Masatoshi
M
Shiono
Department of Medical Oncology, Tohoku University Hospital, Tohoku University, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574, Japan.|Department of Clinical Oncology, Institute of Development, Aging, and Cancer, Tohoku University, Seiryo-machi 4-1, Aoba-ku, Sendai, 980-8575, Japan.
Shin
S
Takahashi
Department of Medical Oncology, Tohoku University Hospital, Tohoku University, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574, Japan.|Department of Clinical Oncology, Institute of Development, Aging, and Cancer, Tohoku University, Seiryo-machi 4-1, Aoba-ku, Sendai, 980-8575, Japan.
Masanobu
M
Takahashi
Division of Biostatistics, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Takuhiro
T
Yamaguchi
Department of Medical Oncology, Tohoku University Hospital, Tohoku University, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574, Japan. chikashi@tohoku.ac.jp.|Department of Clinical Oncology, Institute of Development, Aging, and Cancer, Tohoku University, Seiryo-machi 4-1, Aoba-ku, Sendai, 980-8575, Japan. chikashi@tohoku.ac.jp.
Chikashi
C
Ishioka
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D062905:Central Venous Catheters / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D018962:Phlebotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000451:nursing / Q000706:statistics & numerical data; D025321:Surgery, Computer-Assisted / Q000379:methods; D011795:Surveys and Questionnaires; D014463:Ultrasonography / Q000379:methods; D062666:Vascular Access Devices / Q000009:adverse effects / Q000706:statistics & numerical data
D000970:Antineoplastic Agents
Central venous port; Chemotherapy; Supportive therapy