An Evaluation on Complications and Patient Satisfaction of Port Catheter in Patients with Acute Leukemia in Alzahra and Milad Hospitals, Isfahan, Iran: A One-Year Prospective Analysis

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Surgeury, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Totally implantable central venous access (port-a-cath) is being used increasingly in patients with cancer for chemotherapy administration and other therapeutic procedures. We investigated the rate of port-related complications and patients’ satisfaction in these patients.Methods: We prospectively followed up 44 patients with acute leukemia who underwent port placement in Alzahra and Milad hospitals, Isfahan, Iran, between May 2012 and May 2013. Port-related complications were examined in detail and analyzed statistically. In order to evaluate the patients’ satisfaction, some questionnaires were filled in by patients.Findings: 46 port-a-caths were implanted in 44 patients. Two patients underwent a second placement after removal the first. No case of early complications was reported, in comparison to 16 cases (38.1%) of late complications consisted of rupture and/or migration (9.5%), thrombosis (11.9%), cellulitis (4.8%), bacteremia (14.3%), and erosion (2.4%). The mean patients’ satisfaction was 65.Conclusion: The most common complication reported in our study was the catheter-related blood stream infection. It is suggested that by multimodal educational programs for health care providers and patients, more than 50% of this complication could be avoided. Patients’ satisfaction relates to their background information, and incidence of complication.

Keywords

References

  1. Zaghal A, Khalife M, Mukherji D, El Majzoub N, Shamseddine A, Hoballah J, et al. Update on totally implantable venous access devices. Surg Oncol 2012; 21(3): 207-15.
  2. Johansson E, Engervall P, Bjorvell H, Hast R, Bjorkholm M. Patients' perceptions of having a central venous catheter or a totally implantable subcutaneous port system-results from a randomised study in acute leukaemia. Support Care Cancer 2009; 17(2): 137-43.
  3. Yildizeli B, Lacin T, Batirel HF, Yuksel M. Complications and management of long-term central venous access catheters and ports. J Vasc Access 2004; 5(4): 174-8.
  4. Fischer L, Knebel P, Schroder S, Bruckner T, Diener MK, Hennes R, et al. Reasons for explantation of totally implantable access ports: a multivariate analysis of 385 consecutive patients. Ann Surg Oncol 2008; 15(4): 1124-9.
  5. Johansson E, Bjorkholm M, Bjorvell H, Hast R, Takolander R, Olofsson P, et al. Totally implantable subcutaneous port system versus central venous catheter placed before induction chemotherapy in patients with acute leukaemia-a randomized study. Support Care Cancer 2004; 12(2): 99-105.
  6. Ozdemir NY, Abali H, Oksuzoglu B, Budakoglu B, Akmangit I, Zengin N. It appears to be safe to start chemotherapy on the day of implantation through subcutaneous venous port catheters in inpatient setting. Support Care Cancer 2009; 17(4): 399-403.
  7. Funaki B, Szymski GX, Hackworth CA, Rosenblum JD, Burke R, Chang T, et al. Radiologic placement of subcutaneous infusion chest ports for long-term central venous access. AJR Am J Roentgenol 1997; 169(5): 1431-4.
  8. Gebauer B, El-Sheik M, Vogt M, Wagner HJ. Combined ultrasound and fluoroscopy guided port catheter implantation--high success and low complication rate. Eur J Radiol 2009; 69(3): 517-22.
  9. Biffi R, de Braud F, Orsi F, Pozzi S, Mauri S, Goldhirsch A, et al. Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 1998; 9(7): 767-73.
  10. Kamphuisen PW, Lee AY. Catheter-related thrombosis: lifeline or a pain in the neck? Hematology Am Soc Hematol Educ Program 2012; 2012: 638-44.
  11. Narducci F, Jean-Laurent M, Boulanger L, El Bedoui S, Mallet Y, Houpeau JL, et al. Totally implantable venous access port systems and risk factors for complications: a one-year prospective study in a cancer centre. Eur J Surg Oncol 2011; 37(10): 913-8.
  12. Di Carlo I, Biffi R. Totally implantable venous access devices. Milan, Italy; Springer-Verlag Mailand; 2012.
  13. Huang WT, Chen TY, Su WC, Yen CJ, Tsao CJ. Implantable venous port-related infections in cancer patients. Support Care Cancer 2004; 12(3): 197-201.
  14. Ingram J, Weitzman S, Greenberg ML, Parkin P, Filler R. Complications of indwelling venous access lines in the pediatric hematology patient: A prospective comparison of external venous catheters and subcutaneous ports. Am J Pediatr Hematol Oncol 1991; 13(2): 130-6.
  15. Keung YK, Watkins K, Chen SC, Groshen S, Silberman H, Douer D. Comparative study of infectious complications of different types of chronic central venous access devices. Cancer 1994; 73(11): 2832-7.
  16. Gastmeier P, Geffers C. Prevention of catheter-related bloodstream infections: analysis of studies published between 2002 and 2005. Journal of Hospital Infection 2006; 64(4): 326-35.
  17. Carde P, Cosset-Delaigue MF, Laplanche A, Chareau I. Classical external indwelling central venous catheter versus totally implanted venous access systems for chemotherapy administration: a randomized trial in 100 patients with solid tumors. Eur J Cancer Clin Oncol 1989; 25(6): 939-44.
Journal of Isfahan Medical School
Volume 36, Issue 473 - Serial Number 473
March and April 2018
Pages 309-316

Files

History

  • Receive Date: 25 July 2015
  • Revise Date: 01 June 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics