An analysis of long-term venous access catheters in cancer patients:experience from a tertiary care centre in India

Abstract

Background: Venous access is crucial for cancer management for administration of drugs blood products, antibiotics and periodic sampling.

Aims: To review our experience of long-term venous access devices used over a ten-year period and to analyse the outcome in cancer patients in Indian setting.

Setting and design: A retrospective analysis of data in a tertiary care Regional cancer centre.

Patients and methods: A total of 110 patients with various malignancies requiring long-term venous access were included in the study. A uniform open cut down procedure under local anaesthesia was used and silastic Hickman catheters were inserted in the cephalic or external jugular or internal jugular veins. A record of all complications and catheter loss and final out come were analysed.

Results: A total of 111 catheters were used in 110 patients. Sixty-nine catheters were placed in cephalic, 40 in external jugular, and 2 in internal jugular vein. Duration of catheter indwelling period ranged from 7 to 365 days with a median of 120 days. In 90% of the cases the catheter tip was located either in superior vena cava or in right atrium. Total catheter related complications were observed in 37 (34.54%) patients and catheter loss rate due to complications was 15.4% (17/111).

Conclusions: Long-term venous access using Hickman catheter insertion by open cut down method is a simple, safe and reliable method for administration of chemotherapeutic agents, antibiotics and blood products. The incidence of various complications and catheter loss was acceptable and overall patient satisfaction was good.