Insertion of totally implantable central venous access devices by surgeons

Ann Coloproctol. 2015 Apr;31(2):63-7. doi: 10.3393/ac.2015.31.2.63. Epub 2015 Apr 30.

Abstract

Purpose: The aim of this study is to evaluate the results for the insertion of totally implantable central venous access devices (TICVADs) by surgeons.

Methods: Total 397 patients, in whom TICVADs had been inserted for intravenous chemotherapy between September 2008 and June 2014, were pooled. This procedure was performed under local anesthesia in an operation room. The insertion site for the TICVAD was mainly in the right-side subclavian vein. In the case of breast cancer patients, the subclavian vein opposite the surgical site was used for insertion.

Results: The 397 patients included 73 males and 324 females. Primary malignant tumors were mainly colorectal and breast cancer. The mean operation time was 54 minutes (18-276 minutes). Operation-related complications occurred in 33 cases (8.3%). Early complications developed in 15 cases with catheter malposition and puncture failure. Late complications, which developed after 24 hours, included inflammation in 6 cases, skin necrosis in 6 cases, hematoma in 3 cases, port malfunction in 1 case, port migration in 1 case, and intractable pain at the port site in 1 case.

Conclusion: Insertion of a TICVAD under local anesthesia by a surgeon is a relatively safe procedure. Meticulous undermining of the skin and carefully managing the TICVAD could minimize complications.

Keywords: Central venous catheterization; Maintenance chemotherapy; Vascular access devices.