[Complications After Insertion of a Totally Implantable Venous Access Port in Patients Treated With Chemotherapy for Head and Neck Squamous Cell Carcinoma]

Ann Otolaryngol Chir Cervicofac. 2009 Apr;126(2):43-52. doi: 10.1016/j.aorl.2009.02.005. Epub 2009 Mar 25.
[Article in French]

Abstract

Objectives: To review the occurrence of early and delayed complications after insertion of a totally implantable venous access port (Tivap) in patients treated with chemotherapy for head and neck squamous cell carcinoma.

Material and methods: Monocentric prospective study (2005-2008) undertaken in a tertiary referral center. In all cases, the inserted Tivap was a Celsite ST301 (Braun) model. The insertion procedure was performed in operating room conditions under local anesthesia using a surgical cut-down method. No antibiotic prophylaxis or long-term anticoagulant medications were administered. Two groups were made between experienced and in-training surgeons. All complications occurring from the date of Tivap insertion to the date of its removal or until the closure of the study were included.

Results: The study comprised of 122 patients including 103 males and 19 females; the patients' mean age was 58.5 years (range, 36-80). Twelve (9.8%) had a tracheotomy or tracheostomy and 41 (33.6%) underwent cervical radiotherapy before Tivap insertion. In 63 cases (51.6%), the procedure was performed by a senior surgeon. The inserted vessel was the cephalic vein (84.4%), the external jugular vein (11.5%) or the internal jugular vein (2.5%). Overall, the total number of days of Tivap implantation was 51,403. Altogether, 11 complications (9%) were listed: two (1.6%) early complications and nine (7.4%) delayed complications. We did not uncover a significant statistical relation between complication onset and experience of the operating surgeon, sex, implanted side, tracheotomy, previous radiotherapy, or number of days of Tivap port.

Conclusion: Our study suggests that: (1) complications are rare provided careful implantation and manipulation methods are followed by health personnel; (2) surgical cephalic cut-down is a very reliable method; and 3) antibiotic prophylaxis or long-term anticoagulant medications are not mandatory.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Bacterial Infections / etiology
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / radiotherapy
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation
  • Catheterization, Central Venous / methods
  • Catheters, Indwelling / adverse effects
  • Chemotherapy, Adjuvant
  • Equipment Failure
  • Female
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / radiotherapy
  • Hematoma / etiology
  • Hospitals, University
  • Humans
  • Infusion Pumps, Implantable / adverse effects*
  • Jugular Veins
  • Male
  • Middle Aged
  • Pneumothorax / etiology
  • Prospective Studies
  • Radiotherapy, Adjuvant
  • Subclavian Vein
  • Venous Thrombosis / etiology