Central venous access port implantation procedures and complications

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We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure” Shiono et al (2016).

Abstract:

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 %).

CONCLUSION: Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

Reference:

Shiono, M., Takahashi, S., Takahashi, M., Yamaguchi, T. and Ishioka, C. (2016) Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan. International Journal of Clinical Oncology. June 21st. [Epub ahead of print].

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