Complications of indwelling venous access devices in patients with gynecologic malignancies☆
| Autor: | Charles A. Leath, Jacob M. Estes, Rodney P. Rocconi, Warner K. Huh, J. Michael Straughn, Larry C. Kilgore, Snehal M. Bhoola, Ronald D. Alvarez |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Catheterization Central Venous medicine.medical_specialty Genital Neoplasms Female Deep vein Bacteremia Gynecologic oncology Catheters Indwelling Uterine cancer medicine Humans Aged Retrospective Studies Venous Thrombosis Vaginal cancer business.industry Obstetrics and Gynecology Postoperative complication Middle Aged Staphylococcal Infections medicine.disease Thrombosis Surgery Catheter medicine.anatomical_structure Oncology Fallopian tube cancer Female business |
| Zdroj: | Gynecologic Oncology. 91:591-595 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2003.08.015 |
| Popis: | Objective The purpose of this study was to evaluate the complication rates associated with indwelling venous access devices in patients with gynecologic malignancies. Methods Following IRB approval, a computerized database identified women that had indwelling access devices placed for chemotherapy from March 1999 to June 2001. A retrospective chart review identified 116 venous access devices that were placed in 104 patients. All devices were silicone and had a closed tip design with a three-position valve. Data were collected on patient demographics, clinicopathologic features, type of venous device, and complications. The χ 2 test was used for statistical analysis. Results Of the 104 patients, 79 had ovarian cancer, 11 had uterine cancer, 10 had cervical cancer, 2 had fallopian tube cancer, and 2 had vaginal cancer. The median age was 61 years. There were a total of 116 venous devices placed: 65 external catheters (EC) and 51 subcutaneous ports (SP). Seventy-nine percent of the patients were administered low-dose coumadin (1 mg/day) for catheter clot prophylaxis. There were three operative complications in the EC group and two in the SP group ( P = NS). The most common postoperative complications were infection and thrombosis. Nineteen patients in the EC group experienced a catheter-related infection versus 5 in the SP group ( P = 0.025). In the EC group, there were 11 cases of site infection and 8 cases of line sepsis. In contrast, there were 3 cases of exit site infection and 2 cases of line sepsis in the SP group. Deep vein thrombosis occurred in 5 patients with EC and 3 patients with SP ( P = NS). Twenty-seven patients with EC had the device removed for catheter-related complications versus 2 patients with SP ( P = 0.001). Six patients inadvertently removed their EC. Conclusions There is a significantly higher postoperative complication rate in gynecologic oncology patients with external catheters versus subcutaneous ports. Infection and catheter-related malfunction are more common in patients with external catheters. We recommend the use of subcutaneous ports in the majority of patients with gynecologic malignancies. |
| Databáze: | OpenAIRE |
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