Use of totally implantable central venous access port via the basilic vein in patients with thoracic malignancies.

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概要

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• BACKGROUND: For patients with a thoracic malignancy whose peripheral veins are not suitable for blood access for chemotherapy, we evaluated a totally implantable central venous access port, in which the port is implanted in the ulnar side of the arm and the catheter is introduced via the basilic vein into the superior vena cava (TIAP-BV). METHODS: Twenty-five patients (21 with lung cancer, 2 with malignant pleural mesothelioma, and 2 with thymoma) receiving TIAP-BV were included. Indications, surgical complications, and long-term complications were analyzed. RESULTS: Indications for TIAP-BV were: chemotherapy (17 patients) and chemotherapy with parenteral nutrition (8 patients). The following surgical complications occurred: arrhythmia due to misplacement of the tip of catheter (1 patient); intraoperative conversion from the left to right arm (2 patients); and hematoma at the implantation site (1 patient). Short-term problems were: death 1 week after implantation without the use of TIAP-BV (2 patients). Long-term complications were: skin ulcer at the port site (1 patient); early removal of TIAP-BV because of port site infection (1 patient); catheter occlusion (1 patient); and venous thrombosis of basilic vein (2 patients). In the 22 patients who did not die early or have the device withdrawn early, the median duration of TIAP-BV use was 7 months (range, 1 to 20 months) without any break to the port system, leakage of drugs, or catheter-related infections. CONCLUSION: TIAP-BV can be employed for long-term use for chemotherapy and parenteral nutrition. However, a patient's expected prognosis and infectious disease status at the time of implantation surgery should be considered before the surgery proceeds.

• 2009-06-01

著者

• SATO Kiyoshi

  Department of Microbiology, Sapporo Medical University School of Medicine

• Date Hiroshi

  Department of Thoracic Surgery, Kyoto University

• Sakai Hiroaki

  Department Of Thoracic Surgery Kyoto University Hospital

• MIYAHARA Ryo

  Department of Thoracic Surgery, Faculty of Medicine, Kyoto University

• BANDO Toru

  Department of Organ Preservation Technology, Graduate School of Medicine, Kyoto University

• Date Hiroshi

  京都大学 呼吸器外科

• SONOBE Makoto

  Department of Thoracic Surgery, Kyoto University Hospital

• Bando Toru

  Department Of Organ Preservation Technology Graduate School Of Medicine Kyoto University

• Miyahara Ryo

  Department Of Thoracic Surgery Kyoto University Hospital

• Miyahara Ryo

  Department Of Thoracic Surgery Graduate School Of Medicine Kyoto University

• Sato Kiyoshi

  Department Of Microbiology Sapporo Medical University School Of Medicine

• OKUBO Kenichi

  Department of Thoracic Surgery, Kyoto University Hospital

• FUJINAGA Takuji

  Department of Thoracic Surgery, Kyoto University Hospital

• SHOJI Tsuyoshi

  Department of Thoracic Surgery, Kyoto University Hospital

• CHEN Fengshi

  Department of Thoracic Surgery, Kyoto University Hospital

• HIRATA Toshiki

  Department of Thoracic Surgery, Kyoto University Hospital

• Sakai Hiroaki

  Department Of Anesthesiology Juntendo University Shizuoka Hospital

• Chen Fengshi

  Department Of Thoracic Surgery Graduate School Of Medicine Kyoto University

• Chen Fengshi

  Department Of Cardiovascular Surgery Shizuoka City Hospital

• Okubo Kenichi

  Department Of Thoracic Surgery Kyoto University

• Sonobe Makoto

  Department Of Abdominal And General Sugery Tenri Hospital

• Sonobe Makoto

  Department Of Thoracic Surgery Kyoto University Hospital

• Hirata Toshiki

  Department Of Thoracic Surgery Kyoto University Hospital

• Hirata Toshiki

  Department Of Thoracic Surgery Kyoto University

• Shoji Tsuyoshi

  Department Of Thoracic Surgery Kyoto University

• Date Hiroshi

  Department Of Cancer And Thoracic Surgery Field Of Patho-physiology Okayama University Graduate Scho

• Fujinaga Takuji

  Department Of Thoracic Surgery Kyoto University Hospital

• Sato Kiyoshi

  Department Of Thoracic Surgery Kyoto University Hospital

• Sato Kiyoshi

  Department Of Biological And Chemical Engineering Gunma University

• Okubo Kenichi

  Department Of Thoracic Surgery Graduate School Of Medicine Kyoto University

• Shoji Tsuyoshi

  Department Of Thoracic Surgery Graduate School Of Medicine Kyoto University

• Fujinaga Takuji

  Department Of Thoracic Surgery Kyoto University

• Fujinaga Takuji

  Department of General Thoracic Surgery, Nagara Medical Center, Gifu, Gifu, Japan

• Shoji Tsuyoshi

  Department of Geriatric Medicine, Graduate School of Medicine

• FUJINAGA Takuji

  Department of General Thoracic Surgery, Nagara Medical Center

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