Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

Abstract

Background: A totally implantable venous access port (TIVAP) is an essential component of care for oncology patients. Conventional placement of the TIVAP is performed through the internal jugular vein or the subclavian vein using a tunneled catheter, which involves creating two incisions. However, the conventional technique has several potential limitations. To address these limitations, a single-incision technique without a second incision or subcutaneous tunneling has been extensively tested since first being introduced by Glenn in 2007. Objectives: The purpose of this study was to evaluate the technical success, clinical outcomes, and complications of the single-incision technique for the placement of TIVAPs. Patients and Methods: Between January 2013 and June 2017, 182 TIVAPs were placed by a single-incision technique in 175 patients, including 79 men and 96 women (mean age, 62.4 years; range: 20 - 88 years). Electronic medical records were retrospectively reviewed to obtain patient data, outcomes, and complication rates. Results: A total of 40,594 catheter maintenance days (median, 221.9 days; range, 1 - 889 days) were recorded for 182 TIVAPs in 176 patients. Technical and clinical success rates were both 100%. A total of 25 complications (complication rate, 13.74%) occurred, including catheter occlusion (5.49%), catheter-related infection (5.49%), wound dehiscence (1.10%), catheter kinking (0.55%), venous thrombosis (0.55%), and extravasation during infusion (0.55%). Conclusion: The single-incision technique for TIVAP via the axillary vein was safe and efficient with high technical and clinical success rates. This new technique may be a good alternative to conventional techniques.