Abstract
BackgroundThe requirement of central venous (CV) port implantation is increasing with the increase in the number of cancer patients and advancement in chemotherapy. In our division, medical oncologists have implanted all CV ports to save time and consultation costs to other departments. Recently, upper arm implantation has become the first choice as a safe and comfortable method in our unit. Here we report our experience and discuss the procedure and its potential advantages.MethodsAll CV port implantations (n = 599) performed in our unit from January 2006 to December 2011 were analyzed. Procedural success and complication rates between subclavian and upper arm groups were compared.ResultsBoth groups had similar patient characteristics. Upper arm CV port and subclavian implantations were equivalently successful and safe. Although we only retrospectively analyzed data from a single center, the upper arm group had a significantly lower overall postprocedural complication rate than the subclavian group. No pneumothorax risk, less risk of arterial puncture by ultrasound, feasibility of stopping potential arterial bleeding, and prevention of accidental arterial cannulation by targeting the characteristic solitary basilic vein were the identified advantages of upper arm CV port implantation. In addition to the aforementioned advantages, there is no risk of “pinch-off syndrome,” possibly less patient fear of manipulation, no scars on the neck and chest, easier accessibility, and compatibility with the “peripherally inserted central catheter” technique.ConclusionsUpper arm implantation may benefit clinicians and patients with respect to safety and comfort. We also introduce our methods for upper arm CV port implantation with the videos.
Highlights
The number of cancer patients has been increasing worldwide due to progressive society aging
Patient Characteristics All central venous (CV) port implantations performed in our unit from January
As more physicians become capable of performing upper arm CV port placement, more patients will receive benefits, such as elimination of the pain of routine peripheral intravenous access, infusional angialgia, and extravasation of cytotoxic agents during chemotherapy
Summary
The number of cancer patients has been increasing worldwide due to progressive society aging. Between 2006 and 2011, we implanted about 600 CV ports in the upper arm or upper chest subclavian regions of patients with advanced cancer who required chemotherapy. Choice of upper arm and ultrasound guidance enable surgeons and other physicians such as medical oncologists to safely perform this procedure. This technique can be applied to the ‘‘peripherally inserted central catheter’’ technique. The requirement of central venous (CV) port implantation is increasing with the increase in the number of cancer patients and advancement in chemotherapy. We report our experience and discuss the procedure and its potential advantages
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