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  • Title: [Totally implantable central venous access devices in patients with cancer. Experience at a private oncology center].
    Author: Cortés-Flores AO, Morgan-Villela G, Juárez-Uzeta EA, Fuentes-Orozco C, Jiménez-Tornero J, González-Ojeda A.
    Journal: Cir Cir; 2012; 80(5):429-34. PubMed ID: 23351446.
    Abstract:
    BACKGROUND: Use of totally implantable central venous access ports in cancer patients is a common practice for chemotherapy not excluding early and late morbidity. OBJECTIVE: To report the experience using these devices in a private cancer center. METHODS: A consecutive series of 156 cases of patients using these devices placed by the same surgical team to enhance chemotherapy. They were evaluated over a period of 44 months. Prevalence of early and late complications and days-risk for patient infection was determined. RESULTS: In 140 cases (89.8%) patients underwent placement of totally implantable devices by surgical cut down through the external jugular vein. One case was done (0.6%) through the internal jugular, and another one (0.6%) through the cephalic vein (0.6%). In the remaining 13 cases (8.4%) devices were placed by percutaneous puncture of the subclavian vein. In one case it was impossible to place it by any of the two access ways (0.6%). The prevalence of early complications was 3.22% and of late complications 1.93%. The average days-risk for the development of infection was 473.8/patient. One case had fracture of the catheter during follow up. There was no mortality. DISCUSSION: Overall complication rate was 5.15%, similar to that reported by reference centers, without infection during follow-up. Access through the external jugular vein facilitates correct positioning of the catheter and has fewer complications. CONCLUSIONS: The combination of a trained surgical team and careful monitoring reduces morbidity and prevents infections. Access through the external jugular is recommended for its accessibility and low morbidity.
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