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. 2004 Jul 1;122(4):147-51.
doi: 10.1590/s1516-31802004000400003. Epub 2004 Nov 9.

Totally implantable venous catheters for chemotherapy: experience in 500 patients

Nelson Wolosker  1 , Guilherme Yazbek, Kenji Nishinari, Luiz Caetano Malavolta, Marco Antonio Munia, Marcel Langer, Antonio Eduardo Zerati
Affiliations

Totally implantable venous catheters for chemotherapy: experience in 500 patients

Nelson Wolosker et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context: Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients, although few studies have been done in our environment to analyze the results obtained from the implantation and utilization of such catheters.

Objective: To study the results obtained from the implantation of totally implantable catheters in patients submitted to chemotherapy.

Type of study: Prospective.

Setting: Hospital do Cancer A.C. Camargo, Sao Paulo, Brazil.

Methods: 519 totally implantable catheters were placed in 500 patients submitted to chemotherapy, with preference for the use of the right external jugular vein. Evaluations were made of the early and late-stage complications and patient evolution until removal of the device, death or the end of the treatment.

Results: The prospective analysis showed an average duration of 353 days for the catheters. There were 427 (82.2%) catheters with no complications. Among the early complications observed, there were 15 pathway hematomas, 8 cases of thrombophlebitis of the distal stump of the external jugular vein and one case of pocket infection. Among the late-stage complications observed, there were 43 infectious complications (0.23/1000 days of catheter use), 11 obstructions (0.06/1000 days of catheter use) and 14 cases of deep vein thrombosis (0.07/1000 days of catheter use). Removal of 101 catheters was performed: 35 due to complications and 66 upon terminating the treatment. A total of 240 patients died while the catheter was functioning and 178 patients are still making use of the catheter.

Conclusion: The low rate of complications obtained in this study confirms the safety and convenience of the use of totally implantable accesses in patients undergoing prolonged chemotherapy regimes.

CONTEXTO:: Os dispositivos totalmente implantáveis vêm sendo cada vez mais utilizados para quimioterapia de pacientes oncológicos, porém poucos são os estudos em nosso meio que analisam os resultados obtidos com a implantação e utilização desses cateteres.

OBJETIVO:: Estudar os resultados obtidos com a implantação de cateteres totalmente implantáveis em pacientes submetidos a quimioterapia.

TIPO DO ESTUDO:: Prospectivo.

LOCAL:: Hospital do Câncer A.C. Camargo, São Paulo, Brasil.

MÉTODOS:: Foram colocados 519 cateteres totalmente implantáveis em 500 pacientes a serem submetidos a regime de quimioterapia preferencialmente utilizando-se a veia jugular externa direita. Foram avaliadas as complicações precoces, as tardias e a evolução até a retirada do dispositivo, morte ou fim de tratamento.

RESULTADOS:: A análise prospectiva mostrou duração média dos cateteres de 353 dias. Em 427 (82,2%) cateteres não se observou nenhuma complicação. Entre as complicações precoces, observamos 15 hematomas de trajeto, oito tromboflebites de coto distal de veia jugular externa e uma infecção de bolsa de subcutâneo. Entre as complicações tardias, observamos 43 complicações infecciosas (0,23/1000 dias de uso de cateter), 11 obstruções (0,06/1000 dias de uso de cateter) e 14 tromboses venosas profundas (0,07/1000 dias de uso de cateter). Foram retirados 101 cateteres, 35 devido às complicações e 66 por final de tratamento. 240 pacientes foram a óbito com o cateter funcionante e 178 pacientes ainda o utilizavam para quimioterapia.

CONCLUSÃO:: As baixas taxas de complicação obtidas nesse estudo confirmam a segurança e conveniência do uso dos acessos totalmente implantáveis em pacientes em regime prolongado de quimioterapia.

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Conflict of interest statement

Conflict of interest: Not declared

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