CENTRAL VENOUS CATHETER BASED PORT FOR MULTI-DOSE CHEMOTHERAPY; TECHNIQUES AND COMPLICATIONS

Abstract

Background:  the utility of percutaneous Chemo port devices in the administration of multi-dose systemic chemotherapy in malignancy patients for long term therapy. It is a small port that is implanted under the skin in subcutaneous tissue to allow easy and repeated access to the bloodstream. To avoid thrombophlebitis and extravasation of drugs

Objective: To study the utility of percutaneous Chemo port devices in the administration of multi-dose systemic chemotherapy in malignancy patients.

Methods:   this was a prospective study. The study was done in the department of cardiovascular and thoracic surgery SKIMS soura Srinagar Kashmir .from October 2018 to January 2020.We included 50 patients who were advised for Chemotherapy by the Medical Oncology department .The gender distribution being 38 females and 12 males. The mean age group was 43 and 54 years respectively for females and males.  A single type of port was used, constructed of titanium and silicone. Puncture was done ultrasound guided. All patients had baseline investigation and dopplar for upper limbs and to rule out central venous stenosis.

Results: We included  total 50  patients, 43 (87%) patients completed their chemotherapy regime including .one  (2%) patient who developed ipsilateral pneumothorax which was managed by intercostal tube placement. 2 (4%) patients developed severe wound infection that prompted the instantaneous removal of chemoport device followed by irrigation of the infected pocket and antibiotics. 1 patient developed catheter block which required flushes of heparinised saline. 2 patients required re-orientation of port device for port tilting.One (2%) patient had refractory arrhythmias that did not settle with drugs and hence warranted port removal. None patients had spontaneous extravasation of the port through the skin.

Exclusion criteria: Pediatric patients age less than 18 years. Patients having Central venous stenosis. Patients having deep venous thrombosis of bilateral upper limbs.

Conculsion: Central venous based catheter device is a very good means of delivering chemotherapeutic agents in patients of malignancy who have to receive a multi-dose drug therapy.

Keywords:  Chemotherapy, device implantation, utility, complications and management