Review of implantable intravenous ports in cancer patients

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“We report on the pattern of use and rate of complications of port-a-caths in patients diagnosed with malignant cancer at a single institution.” D’Souza et al (2014).

Reference:

D’Souza, P.C., Kumar, S., Kakaria, A., Al-Sukaiti, R., Zahid, K.F., Furrukh, M., Burney, I.A. and Al-Moundhri, M.S. (2014) Use of port-a-cath in cancer patients: a single-center experience. Journal of Infection in Developing Countries. 8(11), p.1476-1482.

Abstract:

INTRODUCTION: Central venous catheters play an important role in the management of cancer patients. Different types of devices are associated with different patterns of complications. We report on the pattern of use and rate of complications of port-a-caths in patients diagnosed with malignant cancer at a single institution.

METHODOLOGY: The data were collected retrospectively from patients who received the treatment for solid tumors or lymphoma through a port-a-cath at the Sultan Qaboos University Hospital (SQUH) between January 2007 and February 2013.

RESULTS: A total of 117 port-a-caths were inserted in 106 patients. The majority (86; 73.5%) were implanted by an interventional radiologist, and the right internal jugular vein was accessed in 79 (67.5%) patients. Mean catheter indwelling time was 354 (range 3-1,876) days for all patients, 252 (3-1,876) and 389 days (13-1,139) for patients with and without complications, respectively. Thirty (25.6%) port-a-caths were removed prematurely, mainly due to infectious complications, while 17 (14.5%) were removed after completion of treatment. Staphylococcus aureus was the most frequently isolated organism, found in 8 (6.8%) patients. Underlying diagnosis (p < 0.001), chemotherapy regimen (p < 0.001), sensitivity to antibiotics (p = 0.01), and any complication (p < 0.001) were significant factors affecting the duration of port-a-cath use. None of these factors were significant on multivariate cox regression analysis.

CONCLUSIONS: The mean duration of port-a-cath use was almost one year. Infection was the most common complication leading to premature removal, followed by port thrombosis.

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