Total Implantable Central Venous Access Port Implantation in a Hybrid Operating Room: Single Center Results
Abstract
Purpose: To observe the effect of using Ultrasonography (USG) and X-ray Floroscopy (XrF) on perioperative and postoperative complications in order to optimize catheter position during TIVAP implantation in hybrid operating rooms where surgical sterilization can be effectively provided and to share the retrospective results of our technique.
Material and Methods: Patients who underwent Total Implantable Central Venous Access Port Implantation (TIVAP) implantation in our clinic between 01.11.2022 and 31.08.2024 will be retrospectively screened. Electronic patient records will be accessed to collect variables such as age, gender, body mass index (BMI), oncological diagnosis, complications, and duration of TIVAP use. Patients who are not performed by cardiovascular surgeons, who do not have punctures according to USG guidelines, and who do not use XrF will be excluded from the study. In patients who meet the conditions, malposition, pneumothorax, hemothorax will be evaluated in postoperative chest radiographs, the patients' TIVAP usage period until 31.08.2024 will be reached, and the reasons for TIVAP removal will be listed.
Results: The study included 112 patients. No patient developed malposition, pneumothorax, venous thrombosis, arterial puncture or acute bleeding. The most common complication that shortened the duration of TIVAP use the most was infection. 70 patients are currently using TIVAP and are under follow-up.
Conclusion: This series of 112 patients; The success of XrF and USG in the TIVAP implantation procedure performed by cardiovascular surgeons is shown. The fact that no perprocedural complications and malpositions were observed and the infection rate was low compared to current literature was thought to be related to the fact that TIVAP implantation was performed in operating rooms where USG, XrF could be used and a sterile area could be created for the surgeon.
Keywords
Ethical Statement
This study was approved by Dokuz Eylul University Non-interventional Research Ethics Committee (Date: 18.09.2024, Decision No: 2024/31-14).
Supporting Institution
Dokuz Eylul University
Thanks
We would like to thank scrub nurse Gözde Baykal for her contributions to the study and all other staff of the Department of Cardiovascular Surgery at Dokuz Eylül University for their support.
References
- Zhang K-C, Wang H, Deng Y, et al. Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas. World J Gastroenterol 2020;26(25):3517–3527.
- Niederhuber JE, Ensminger W, Gyves JW, et al. Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 1982;92(4):706–712.
- Di Carlo I, Pulvirenti E, Mannino M, et al. Increased use of percutaneous technique for totally implantable venous access devices. Is it real progress? A 27-year comprehensive review on early complications. Ann Surg Oncol 2010;17(6):1649–1656.
- Kim DH, Ryu DY, Jung HJ, Lee SS. Evaluation of complications of totally implantable central venous port system insertion. Exp Ther Med 2019;17(3):2013–2018.
- Tabatabaie O, Kasumova GG, Eskander MF, et al. Totally implantable venous access devices: a review of complications and management strategies. Am J Clin Oncol 2017;40(1):94–105.
- Morris SL, Jaques PF, Mauro MA. Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology 1992;184(1):149–151.
- Miccini M, Cassini D, Gregori M, et al. Ultrasound-guided placement of central venous port systems via the right internal jugular vein: are chest x-ray and/or fluoroscopy needed to confirm the correct placement of the device? World J Surg 2016;40(10):2353–2358.
- Ma L, Zhou Y, Zhou Y, et al. Clinical practice guidelines for breast cancer implantable intravenous infusion ports: Chinese Society of Breast Surgery practice guidelines 2021. Chin Med J (Engl) 2021;134(16):1894–1896.
- Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: ESMO clinical practice guidelines. Ann Oncol 2015;26(Suppl 5):v152–v168.
- Glauser F, Breault S, Rigamonti F, et al. Type malposition of peripherally inserted central catheters: a prospective randomized controlled trial to compare bedside insertion to fluoroscopically guided placement. Eur Radiol 2017;27:2843–2849.
- Thiel K, Kalmbach S, Maier G, et al. Standardized procedure prevents perioperative and early complications in totally implantable venous-access ports: a complication analysis of more than 1000 TIVAP implantations. Langenbecks Arch Surg 2022.
- Addeo L, Valeriano C, Valcher S, et al. Ultrasound-guided puncture of femoral veins versus standard palpation approach in patients undergoing pulmonary vein isolation. J Interv Card Electrophysiol 2025 Jan 6. Epub ahead of print.
- Hamilton HC, Foxcroft DR. Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring long-term intravenous therapy. Cochrane Database Syst Rev 2007;(3):CD004084.
- 14.D'Souza PC, Kumar S, Kakaria A, et al. Complications and management of totally implantable central venous access ports in cancer patients at a university hospital in Oman. Sultan Qaboos Univ Med J 2021;21(1):e103–e109.
- Guan X, Yan H, Zhang J, et al. Risk factors of infection of totally implantable venous access port: a retrospective study. J Vasc Access 2023;24(6):1340–1348.
Total Implantable Central Venous Access Port Implantation in a Hybrid Operating Room: Single Center Results
Abstract
References
- Zhang K-C, Wang H, Deng Y, et al. Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas. World J Gastroenterol 2020;26(25):3517–3527.
- Niederhuber JE, Ensminger W, Gyves JW, et al. Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 1982;92(4):706–712.
- Di Carlo I, Pulvirenti E, Mannino M, et al. Increased use of percutaneous technique for totally implantable venous access devices. Is it real progress? A 27-year comprehensive review on early complications. Ann Surg Oncol 2010;17(6):1649–1656.
- Kim DH, Ryu DY, Jung HJ, Lee SS. Evaluation of complications of totally implantable central venous port system insertion. Exp Ther Med 2019;17(3):2013–2018.
- Tabatabaie O, Kasumova GG, Eskander MF, et al. Totally implantable venous access devices: a review of complications and management strategies. Am J Clin Oncol 2017;40(1):94–105.
- Morris SL, Jaques PF, Mauro MA. Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology 1992;184(1):149–151.
- Miccini M, Cassini D, Gregori M, et al. Ultrasound-guided placement of central venous port systems via the right internal jugular vein: are chest x-ray and/or fluoroscopy needed to confirm the correct placement of the device? World J Surg 2016;40(10):2353–2358.
- Ma L, Zhou Y, Zhou Y, et al. Clinical practice guidelines for breast cancer implantable intravenous infusion ports: Chinese Society of Breast Surgery practice guidelines 2021. Chin Med J (Engl) 2021;134(16):1894–1896.
- Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: ESMO clinical practice guidelines. Ann Oncol 2015;26(Suppl 5):v152–v168.
- Glauser F, Breault S, Rigamonti F, et al. Type malposition of peripherally inserted central catheters: a prospective randomized controlled trial to compare bedside insertion to fluoroscopically guided placement. Eur Radiol 2017;27:2843–2849.
- Thiel K, Kalmbach S, Maier G, et al. Standardized procedure prevents perioperative and early complications in totally implantable venous-access ports: a complication analysis of more than 1000 TIVAP implantations. Langenbecks Arch Surg 2022.
- Addeo L, Valeriano C, Valcher S, et al. Ultrasound-guided puncture of femoral veins versus standard palpation approach in patients undergoing pulmonary vein isolation. J Interv Card Electrophysiol 2025 Jan 6. Epub ahead of print.
- Hamilton HC, Foxcroft DR. Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring long-term intravenous therapy. Cochrane Database Syst Rev 2007;(3):CD004084.
- 14.D'Souza PC, Kumar S, Kakaria A, et al. Complications and management of totally implantable central venous access ports in cancer patients at a university hospital in Oman. Sultan Qaboos Univ Med J 2021;21(1):e103–e109.
- Guan X, Yan H, Zhang J, et al. Risk factors of infection of totally implantable venous access port: a retrospective study. J Vasc Access 2023;24(6):1340–1348.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Research Article |
| Authors | |
| Publication Date | May 31, 2025 |
| Submission Date | February 5, 2025 |
| Acceptance Date | March 4, 2025 |
| Published in Issue | Year 2025 Volume: 9 Issue: 2 |
