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Chirurgie 1. April 2012

Totally implantable central venous access devices: results of a mono-centre series of 1610 port implantations performed under ultrasound and fluoroscopic guidance

BACKGROUND: A mono-centre series of 1610 percutaneous port implantations is evaluated. Methods: From 2005 to 2011 1610 ports were implanted in 1575 patients at the Oncologic Surgical Department of "San Martino" Hospital in Genoa, Italy, in the operating rooms of the Interventional Radiology, using local anesthesia and the Seldinger's percutaneous technique. The right internal jugular vein was the access of first choice. All the cases were performed under ultrasound and fluoroscopic guidance. Results: The success rate was 99.8%. No early major complications were observed. Late major complications were observed: 22 (1.4%) bloodstream infections and 21 (1.3%) pocket or tunnel infections with an overall port-related major infection rate of 2.7%. The other late complications were 18 skin necroses and erosions (1.1%), 5 secondary malpositions (0.3%), and 10 vein thromboses (0.6%). Conclusions: In the percutaneous technique, there is a general agreement on the right internal jugular vein, as first choice. The ultrasonography and fluoroscopy, performed during the procedure, help to reduce up to eliminate the early major complications.

R. Scordamaglia, E. Romairone, S. Scabini, E. Rimini, L. De Marini, R. Boaretto, G. P. Damiani, A. Massobrio, V. Belgrano, V. Ferrando, European Surgery 2/2012

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