A practical approach to the management of colorectal cancer during the COVID-19 crisis in the reference cancer treatment center in Tunisia.

COVID-19 is an exceptional public healthcare emergency that affected all countries. The corona virus pandemic has made the treatment of all cancers difficult. This international phenomenon represents an outbreak in medicine and this situation is a major issue for all patients, whether they are infected with the virus or not. Colorectal cancer is one of the most common malignant tumors of the digestive tract which needs special multidisciplinary care. Treatment modalities including chemotherapy and targeted therapies can weaken the immune system and then cause serious or lethal coronavirus infections. This document gives an idea about how we dealt to protect patients with colorectal cancer at Salah Azaiez Institute during COVID 19 pandemic.

[Totally implantable venous access ports by cephalic vein cut-down for patients receiving chemotherapy]. / Impact thérapeutique de l'utilisation de la veine céphalique pour la mise en place des chambres implantables pour chimiothérapie.

BACKGROUND: The use of an implantable room has become indispensable in the clinical practice for the cancer patients. The increasing use of these devices was associated with a greater incidence of complications. AIM: To verify the feasibility of the cephalic vein cut-down technique for placement of venous access devices. METHODS: A prospective study of 58 port placements was performed at our department of general surgery. The surveillance of devices was collectively insured by the operator and by the oncologists. RESULTS: The indication for implantation was the infusion of intravenous chemotherapy in patients with colorectal cancer in 55.1% cases and breast cancer in 27.5%. The specific complication rate was 7%. The cephalic vein cut-down approach was used successful in 45 (77.5%) patients. When the cephalic vein could not be used, a percutaneous technique was employed using the subclavian vein in 22.4% of the patients. CONCLUSION: Cephalic vein cut-down technique should be considered a safe and feasible approach for placement of venous access devices.