[Role of totally implantable systems for long-term vascular access in the treatment of the neoplastic patient]

摘要: Objective To assess retrospectively the effectiveness, safety and impact on quality of life Subcutaneous Infusion Ports (SIPs) for prolonged venous access in treatment neoplastic patients. Design Retrospective analysis a case series collected-during 30 months (April 1991-September 1993). Setting General Surgery Division Radiochemotherapy Service. Participants 35 patients (23 male, 12 female), aged between 27-80 years, received 37 SIPs. 2 34 were affected by neoplasm; 1 patient had short gut syndrome secondary to massive small bowel resection. Interventions The SIP was implanted all operating room with Seldinger technique ("catheter over wire"). suclavian vein, through an infraclavicular approach, only site access. One hepatic artery. All chemotherapy. parenteral nutrition. An external infusion device (CADD-1, CADD-plus, Pharmacia) used 13 continuous either 5-Fluoro-Uracil (1000 mg/m2/die 5 days, every 28 days) or 5-Fluoro-Deoxy-Uridine (0.15-0.30 mg/kg/die 14 days). management required port "flush" normal saline solution heparin (100 U/ml) at least 40 using Huber needle. treated as outpatients. Main outcome measures intraoperative long-term complications, recorded charts patients, reviewed. rate complications assessed procedures. Long-term (7 excluded lack follow up data). Incidence analyzed considering cumulative permanence time single patient. Results We 4 (10.8%). None them stop procedure delay implant SIP. During follow-up period (range 1-18 months) we major complication (pleural effusion TPN extravasation), that is 3.5% (1/8255 days), 3 minor (10.7% patients; 1/2751.6 Patient tolerance good cases. Conclusions safe effective stress need wider use this type