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Objective:To investigate the clinical effect of upper arm central venous port in cancer patients.Methods:A total of 500 patients with tumor were selected as the study subjects from March 29, 2018 to January 19 2020. Complications such as catheter-related thrombosis and catheter-related bloodstream infection during the indwelling period were recorded.Results:One patient with severe superior vena cava syndrome failed to be intubated. The other 499 patients were successfully intubated with a success rate of 99.8% (499/500). The rate of complications was 2.6% (13/499), and the rate of catheter-related bloodstream infection was 0.029‰ (4/139 614) in 4 cases, the incidence of catheter-related thrombus was 0.057‰ (8/139 614) in 8 cases. There were 1 case of body turnover, 1 case of median nerve injury, 1 case of local tissue necrosis and 1 case of lymphatic leakage. Extubation was planned in 15 patients, and unplanned extubation in 6 patients due to complications.Conclusions:The upper arm port has less complications and is suitable for patients with tumor chemotherapy and long-term need of infusion. It is worthy of clinical promotion.
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Objective To systematically evaluate the application efficacies of the peripherally inserted central catheter (PICC) and venous port access (VPA) during chemotherapy in the patients with malignant tumor.Methods The research data published in CNKI,WanFang Database and Pubmed Database were collected from October 2008 to December 2016.The related researches were screened according to the inclusion criteria.Then the meta analysis was performed by using the Revman Manager 5.3 software.Results Finally 63 articles were included for conducting the meta analysis,involving 11 296 patients.The one-time catheter placing success rate of VPA and PICC was investigated by 30 included articles,and the merged effect showed that the difference had no statistical significance (OR =0.96,95 ％ CI:0.75-1.23,P＞0.05).The analysis results of 16 articles showed that the proportion of the catheter indwelling time ≥ 1 year in the patients adopting VAP was higher than that in the patients adopting PICC (OR =27.17,95 ％ CI:18.08-40.83,P＜0.05).The incidence rate of complications in the patients adopting VPA was lower than that in the patients adopting PICC (OR =0.19,95 ％ CI:0.16-0.22,P＜0.01).The living quality of VPA and PICC was investigated by 11 included articles,which showed that the living quality in the VAP group was significantly higher than that in the PICC group (OR=8.53,95％CI:5.88-12.38,P＜0.05).Conclnsion The indwelling time of VPA during chemotherapy in the patients with malignant tumor is longer,the incidence rate of complications is lower and the patient's living quality is higher.
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Objective To analyze the difference of the venous port access (VPA) and peripherally inserted central catheter (PICC) in cancer chemotherapy.Methods All eligible studies on VPA and PICC were searched in the databases of PubMed,China National Knowledge Internet (CNKI),Chinese Biomedical Database (CBM),WANFANG Database and VIP Database.Literatures screening,quality evaluation and data extraction were conducted according to Cochrane Handbook;Meta-analysis was calculated by using RevMan 5.2.Results Twenty-nine studies with a total of 4 449 cases of patients were included in this Meta-analysis,with 1 912 cases in experimental group which adopted VPA and 2 537 cases in controlled group which adopted PICC.Experimental group had advantages in the average catheter retention time (SMD=3.36,95％CI 2.51-4.21) and quality of life (RR=1.61,95％CI 1.15-2.24) compared with controlled group.The overall complication rate (RR=0.26,95％CI 0.20-0.34,P＜0.01),phlebitis incidence (RR=0.08,95％CI 0.04-0.16,P＜0.01),catheter infection incidence (RR=0.32,95％CI 0.23-0.44,P＜0.01),catheter obstruction incidence (RR=0.32,95％CI 0.22-0.48,P＜0.01),catheter dystopy incidence (RR=0.18,95％CI 0.09-0.37,P＜0.01) in experimental group were remarkably lower than that in controlled group.However,no significant difference was found between the two groups in the incidence of the puncture success rate for the first time,errhysis or hematoncus,thrombus and catheter leakage (P ＞0.05).Conclusions Compared with PICC,VPA had advantages in a long retention time,fewer complications and few influence on quality of life.Therefore,VPA should be widely used in cancer chemotherapy.
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Objective To compare the effects of venous port access ( VPA ) with peripherally inserted central catheters ( PICC) in patients with breast cancer .Methods 120 cases with breast cancer were divided into 2 groups from Jan.2009 to Dec.2010,among whom 60 cases were with VPA when receiving operation , and the other 60 cases were with PICC after the operation .The success rate of catheterization , duration of catheter in-dwelling and catheter-related complications of the 2 groups were compared .Results The one-time success rate of catheterization was 100%in VPA group and 66.7%in PICC group .The catheters were retained for more than 12 months in 59 cases in VPA group,while only 4 cases in PICC group retained catheter for more than 12 months. The complications occurred to 1 case in VPA group ( 1.7%) and 9 cases in PICC group ( 15%) .Conclusion VPA is an ideal pathway for chemotherapy of patients with breast cancer , which can reduce nursing work and is worth to be promoted in clinical practice .
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Objective To compare the effects of peripherally inserted central catheter(PICC)and venous port access (VPA)on the complication incidence of breast cancer.Methods A total of 191 breast cancer patients with VPA and 218 ones with PICC for chemotherapy from January 2012 to January 2014 were involved.The two groups were compared in respect of incidence of complications during intubation.Result The complication incidence in the VPA group was lower than the PICC group(P<0.05). Conclusion VPA is an ideal pathway for intravenous infusion in breast cancer patients undergoing chemotherapy.
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Subclavian venous catheterization was previously frequently performed, but because of life-threatening complications such as hemothorax, pneumothorax, mediastinal hematoma, and myocardial injury, its use has become less common. However, this practice has some advantages in patient mobility, secured dressing, and rapidity and adequacy of vascular access. In some situations where patient comfort is an especially important consideration, such as with totally implantable venous port insertion for chemotherapy, the subclavian route can be a good choice if an experienced and well-trained faculty is available. The authors have had recent experience with pinch-off syndrome-in other words, spontaneous catheter fracture-in 3 patients who had undergone venous port implantation through the right subclavian route. Through these cases, we intend to review the dangers of subclavian venous catheterization, the causes of pinch-off syndrome, and its clinical presentation, progress, treatments, and prevention.
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Humans , Bandages , Catheterization , Catheters , Hematoma , Hemothorax , PneumothoraxABSTRACT
OBJECTIVE: To assess the technical success and complication rates of the radiologic placement of central venous ports via the internal jugular vein. MATERIALS AND METHODS: We retrospectively reviewed 1254 central venous ports implanted at our institution between August 2002 and October 2009. All procedures were guided by using ultrasound and fluoroscopy. Catheter maintenance days, technical success rates, peri-procedural, as well as early and late complication rates were evaluated based on the interventional radiologic reports and patient medical records. RESULTS: A total of 433386 catheter maintenance days (mean, 350 days; range 0-1165 days) were recorded. The technical success rate was 99.9% and a total of 61 complications occurred (5%), resulting in a post-procedural complication rate of 0.129 of 1000 catheter days. Among them, peri-procedural complications within 24 hours occurred in five patients (0.4%). There were 56 post-procedural complications including 24 (1.9%, 0.055 of 1000 catheter days) early and 32 (2.6%, 0.074 of 1000 catheter days) late complications including, infection (0.6%, 0.018 of 10000 catheter days), thrombotic malfunction (1.4%, 0.040 of 1000 catheter days), nonthrombotic malfunction (0.9%, 0.025 of 1000 catheter days), venous thrombosis (0.5%, 0.014 of 1000 catheter days), as well as wound problems (1.1%, 0.032 of 1000 catheter days). Thirty six CVPs (3%) were removed due to complications. Bloodstream infections and venous thrombosis were the two main adverse events prolonging hospitalization (mean 13 days and 5 days, respectively). CONCLUSION: Radiologic placement of a central venous port via the internal jugular vein is safe and efficient as evidenced by its high technical success rate and a very low complication rate.
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Catheterization, Central Venous/methods , Fluoroscopy , Jugular Veins , Postoperative Complications/epidemiology , Radiography, Interventional , Republic of Korea/epidemiology , Retrospective Studies , Treatment Outcome , Ultrasonography, InterventionalABSTRACT
Objective To investigate the incidence of nosocomial infection of placing peripherally inserted central catheter (PICC) and venous port acess(VPA) in children with leukemia. Methods 60 cases with leukemia were treated in our hospital from January 2005 to September 2009.35 cases were mail, 25 cases were femail.Their ages ranged from 2.0 to 16.5 years old.42 cases fell to the PICC group, hospital-ization for 202 times, 18 cases belonged to the VPA group, hospitalization for 109 times. The incidence of infection in hospital, infection site, common pathogens and prognosis of two groups were analyzed retro-spectively.Results The incidence of fever and increasing of C-reactive protein of the PICC group were significantly lower than those of the VPA group. There was no difference of the incidence of white blood cells decreasing between two groups. The incidence of infection in hospital in the PICC group was 38.61%, higher than 28.44% of the VPA group. Their difference was significant. There was significant difference of the distribution of infection between two groups. There was no significant difference of the major pathogens of sputum culture and blood culture between two groups. Conclusions Using venous port acess(VPA) could reduce the incidence of infection in hospital compared using peripherally insertied central catheters in children with leukemia, so venous port acess( VPA ) may be safer.
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A 3-year-old girl with a primitive neuroectodermal tumor (PNET) and a 6-year-old girl with acute lymphoid leukemia were referred to us because of problems with their implantable central venous ports (Port-A-Cath(R)). On physical examination, the ports were upside-down, so a needle could notbe inserted through the membrane of the port. Right lateral side view of the chest radiogram confirmed port inversion in both cases. At operation, the ports were inverted and the transfixing sutures were totally absorbed. The ports were rotated 180 degrees and anchoring sutures placed.
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Child , Child, Preschool , Female , Humans , Membranes , Needles , Neuroectodermal Tumors, Primitive , Physical Examination , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Sutures , ThoraxABSTRACT
A 3-year-old girl with a primitive neuroectodermal tumor (PNET) and a 6-year-old girl with acute lymphoid leukemia were referred to us because of problems with their implantable central venous ports (Port-A-Cath(R)). On physical examination, the ports were upside-down, so a needle could notbe inserted through the membrane of the port. Right lateral side view of the chest radiogram confirmed port inversion in both cases. At operation, the ports were inverted and the transfixing sutures were totally absorbed. The ports were rotated 180 degrees and anchoring sutures placed.
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Child , Child, Preschool , Female , Humans , Membranes , Needles , Neuroectodermal Tumors, Primitive , Physical Examination , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Sutures , ThoraxABSTRACT
PURPOSE: We evaluated the results and complications of implantable port placement between the interventional radiological procedure and the surgical procedure. METHODS: From April 2001 to December 2003, 151 implantable ports were placed in 135 patients by an interventional radiologist and 191 ports were placed in 185 patients by a surgeon. RESULTS: The implantable port was successfully placed in all cases. The duration of catheterization was 219.8 days for the interventional radiological procedure and 203.8 days for the surgical procedure. 139 patients underwent port placement via the internal. jugular vein using the peel-away sheath by the interventional radiologist and 163 patients had their ports placed via the external jugular vein cut-down method by the surgeon. Early complications that occurred were pulmonary air embolism (1 case) and hematoma (1 case) for the radiological procedure and catheter malposition (1 case) for the surgical procedure. Late complications that occurred were infection (24 cases), catheter migration or occlusion (6 cases), catheter-related fever (4 cases) for the radiological procedure and infection (7 cases), migration (3 cases), central vein thrombosis (1 case), catheter-related fever (2 cases) for the surgical procedure. CONCLUSION: The safety of the surgical central venous port placement was high and the complication rate was low. In comparison with the interventional radiological procedure, the surgical procedure may be considered as a potentially useful primary procedure for implantable central venous port placement.