A Monocentric Analysis of Implantable Ports in Cancer Treatment: Five-Year Efficacy and Safety Evaluation

Cancers Pub Date : 2024-08-09 DOI:10.3390/cancers16162802
Adel Abou-Mrad, Luigi Marano, Rodolfo J Oviedo
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Abstract

Background: Daily clinical practice requires repeated and prolonged venous access for delivering chemotherapy, antibiotics, antivirals, parenteral nutrition, or blood transfusions. This study aimed to investigate the performance and the safety of totally implantable vascular access devices (TIVADs) over a 5-year follow-up period through a standardized well-trained surgical technique and patient management under local anesthesia. Methods: In a retrospective, observational, and monocentric study, 70 patients receiving POLYSITE® TIVADs for chemotherapy were included. The safety endpoints focused on the rate of perioperative, short-term, and long-term complications. The performance endpoints included vein identification for device insertion and procedural success rate. Results: The study demonstrated no perioperative or short-term complications related to the TIVADs. One (1.4%) complication related to device manipulation was identified as catheter flipping, which led to catheter adjustment 56 days post-placement. Moreover, one (1.4%) infection due to usage conditions was observed, leading to TIVAD removal 3 years and 4 months post-surgery. Catheter placement occurred in cephalic veins (71.4%), subclavian veins (20%), and internal jugular veins (8.6%). The procedural success rate was 100%. Overall, the implantable ports typically remained in place for an average of 22.4 months. Conclusions: This study confirmed the TIVADs’ performance and safety, underscored by low complication rates compared to published data, thereby emphasizing its potential and compelling significance for enhancing routine clinical practice using a standardized well-trained surgical technique and patient management.
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癌症治疗中植入式端口的单中心分析:五年疗效和安全性评估
背景:日常临床实践需要反复、长时间的静脉通路,以进行化疗、抗生素、抗病毒药物、肠外营养或输血。本研究旨在通过训练有素的标准化手术技术和局部麻醉下的患者管理,调查全植入式血管通路装置(TIVAD)在 5 年随访期内的性能和安全性。方法:在一项回顾性、观察性和单中心研究中,纳入了 70 名接受 POLYSITE® TIVAD 化疗的患者。安全性终点主要关注围手术期、短期和长期并发症的发生率。性能终点包括插入装置的静脉识别率和手术成功率。研究结果研究表明,围手术期或短期并发症均与 TIVAD 无关。有一起(1.4%)与设备操作有关的并发症被确认为导管翻转,导致在置入后 56 天调整导管。此外,还观察到一次(1.4%)因使用条件造成的感染,导致术后 3 年零 4 个月拆除了 TIVAD。导管置入部位包括头静脉(71.4%)、锁骨下静脉(20%)和颈内静脉(8.6%)。手术成功率为 100%。总体而言,植入式端口通常平均保留 22.4 个月。结论:这项研究证实了 TIVAD 的性能和安全性,与已公布的数据相比,其并发症发生率较低,从而强调了它的潜力,以及利用训练有素的标准化手术技术和患者管理来加强常规临床实践的重要意义。
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