Complications After Implantation of Subcutaneous Central Venous Ports: Focus on Infection and Catheter Pinch-off

Abstract

Objective The objective of this study was to determine the causes of postoperative complications associated with subcutaneous central venous ports. Summary of Background Data Central venous ports were subcutaneously implanted in 523 patients between January 2005 and December 2013. Methods The purpose of port implantation was administration of chemotherapy in 439 patients and home central venous nutrition in 84 patients. The underlying disease was malignant in 481 patients and benign in 42. Results The median follow-up was 12 months (range, 1–99 months), and postoperative complications developed in 69 patients (13%). Infection occurred in 40 patients (7.6%) and catheter pinch-off in 11 patients (3%). Significant risk factors for infection were nutritional port placement (P < 0.001) and use of a femoral vein approach (P = 0.001). A left subclavian approach was a significant risk factor for catheter pinch-off (P = 0.003). Conclusions Postoperative complications, mainly infections and catheter pinch-off, developed in 13% of the patients. As for measures against complications, a femoral vein approach should be avoided to prevent infection. Moreover, because ports for parenteral nutrition require multiple punctures, methods to reduce the number of punctures and techniques for disinfection and management should be reevaluated. To prevent catheter pinch-off, an internal jugular vein approach should be used instead of a left subclavian approach.