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  • Title: Reasons for explantation of totally implantable access ports: a multivariate analysis of 385 consecutive patients.
    Author: Fischer L, Knebel P, Schröder S, Bruckner T, Diener MK, Hennes R, Buhl K, Schmied B, Seiler CM.
    Journal: Ann Surg Oncol; 2008 Apr; 15(4):1124-9. PubMed ID: 18214621.
    Abstract:
    BACKGROUND: The objective of this study was to analyze factors leading to explantation of totally implanted access ports (TIAPs) and to assess its occurrence and clinical relevance. METHODS: Of 438 patient consecutive patients with a port explantation, 385 were eligible for this retrospective cohort study. Reasons for explantation as well as demographic, clinical, and surgical characteristics were analyzed by univariate and multivariate models. RESULTS: The diagnoses leading to TIAP implantation were hematological malignancies in 142 patients (36.8%), breast cancer in 103 patients (26.8%), gastrointestinal cancer in 76 patients (19.8%), nonmalignant diseases in 46 patients (11.9%), and other malignant diseases in 18 patients (4.7%). The reasons for TIAP explantation were infection in 178 patients (46.2%), end of treatment in 129 patients (33.5%), thrombosis in 44 patients (11.4%), TIAP dysfunction in 22 patients (5.7%), and other reasons in 12 patients (3.2%). At the time of TIAP explantation, 115 patients (29.9%) were receiving chemotherapy, and 49 patients (12.7%) were considered immunocompromised. In case of TIAP explantation due to infection, the median length of TIAP in situ time was 303.3 days, whereas the cumulative 10-day and 30-day explantation rates were 2.8% and 10.6%, respectively. By multivariate models, TIAP explantation due to infection is statistically significantly decreased in patients with breast cancer (P < .01) but significantly increased in patients with recurrent TIAP implantation and with ongoing chemotherapy (P < .01). CONCLUSIONS: TIAP explantations are caused primarily by late-term complications, mainly infections. The subsequent interruption of ongoing treatment makes further efforts necessary to reduce such complications.
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