BACKGROUND Central venous access is essential for administering chemotherapy in patients with gastrointestinal cancer.Peripherally inserted central catheters(PICC)and totally implantable venous access ports(TIVAP)are ...BACKGROUND Central venous access is essential for administering chemotherapy in patients with gastrointestinal cancer.Peripherally inserted central catheters(PICC)and totally implantable venous access ports(TIVAP)are widely used,but comparative data regarding their impact on catheter-related complications and quality of life(QoL)remain limited.AIM To evaluate the impact of TIVAPs compared with PICC on catheter-related complications and QoL in patients with gastrointestinal cancer undergoing chemotherapy.METHODS This retrospective study included adults with gastrointestinal cancer who underwent central venous access device insertion for chemotherapy at our institution between December 2021 and December 2024.Inclusion criteria encompassed indications for intermittent intravenous chemotherapy,anticipated treatment duration of≥12 weeks,an adequate preoperative hematologic profile,accessible upper body veins,and complete medical records.Patients were excluded if they had an anticipated survival of less than three months,active systemic infection,severe thrombosis or coagulopathy,communication barriers,or an urgent need for dialysis access.Patients were assigned to either the PICC or TIVAP group based on device type.Data collected included demographic variables,cancer characteristics,insertion procedure details,complications,and QoL,assessed via the EuroQol 5-Dimensions-3 levels,visual analogue scale,and the European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30.RESULTS A total of 346 patients were analyzed.Baseline demographic,clinical,and cancer characteristics were similar between groups.The TIVAP group demonstrated a significantly lower incidence of catheter-related complications than the PICC group,with no pneumothorax occurring in either group.QoL assessments at baseline were comparable.At one month,the TIVAP group exhibited significantly higher EuroQoL Five Dimensions health state scores and QLQ-C30 global health status scores.Multivariate analysis identified TIVAP use,catheter tip placement in the distal superior vena cava/right atrium,prophylactic antibiotic administration,and antimicrobial dressing application as independent protective factors associated with reduced complications and improved QoL.CONCLUSION In patients with gastrointestinal cancer undergoing chemotherapy,TIVAPs are associated with a lower incidence of catheter-related complications and improved QoL than PICCs.Optimal device selection,precise catheter tip positioning,and effective perioperative management are critical for minimizing complications and enhancing patient-reported outcomes during treatment.展开更多
Background: As the prognosis of lung cancer (LC) patients improves, subcutaneously implanted central venous access device ports (CV-ports) have frequently been used for continuing chemotherapy (CC) or palliative care ...Background: As the prognosis of lung cancer (LC) patients improves, subcutaneously implanted central venous access device ports (CV-ports) have frequently been used for continuing chemotherapy (CC) or palliative care (PC). In this study, we examined the clinical course of LC patients with subcutaneously implanted CV-ports from the time of receiving chemotherapy to the endpoint of cancer. Materials and Methods: We retrospectively reviewed the clinical data and treatment history of LC patients with subcutaneously implanted CV-ports between June 2008 and November 2013 using clinical records and a pharmacy database. Results: Of the 132 LC patients with subcutaneously implanted CV-ports, 79 (59.8%) had CV-ports for CC (the CC group) and 53 (40.2%) had CV-ports for PC (the PC group). After CV-port implantation, LC patients in the CC group received a median of two regimens with a median of 6 cycles. The median survival time of patients in the CC and PC groups was 457 and 44 days, respectively. In the CC group, the median survival time of small cell and non-small cell LC patients was 342 (95% confidence interval, 235 - 627) and 563 (95% confidence interval, 368 - 728) days, respectively. Nine patients (6.8%) had their CV-ports removed due to complications. Forty (30.3%) of the 132 enrolled patients were referred for at-home PC. The at-home death rate observed among these 40 patients was 30.0% (N = 12). Conclusion: CV-ports may contribute to seamless oncological care.展开更多
目的评估经皮原位隧道式带涤纶套透析导管(tunnel cuffed central venous catheter,TCC)再置入技术的安全性、有效性。方法选取2023年1月─2024年12月四川大学华西医院肾脏内科收治符合条件的存留有原TCC皮下隧道需再次置入导管的血液...目的评估经皮原位隧道式带涤纶套透析导管(tunnel cuffed central venous catheter,TCC)再置入技术的安全性、有效性。方法选取2023年1月─2024年12月四川大学华西医院肾脏内科收治符合条件的存留有原TCC皮下隧道需再次置入导管的血液透析患者。收集患者一般情况、血液透析情况、既往导管使用情况等信息。所有患者均尝试使用原TCC皮下隧道原位再置入导管,如未成功,则再穿刺后重新置入TCC。记录手术技术手段、手术时间、并发症、手术后导管使用情况等信息。结果共纳入53例患者,45例成功使用原皮下隧道置入导管,8例患者再穿刺成功后置入新导管。所有患者均顺利置入导管并使用,经原隧道原位置管成功率84.91%,手术时间较再穿刺置管患者减少(t=5.142,P=0.002)。手术后均无大出血、感染等手术并发症,手术后透析导管血流量为(233.77±17.23)ml/min。结论X线引导下,原位隧道式带涤纶套透析导管的再置入技术具有较高的安全性和有效性,在一定程度上缩短操作时间、降低手术难度,为长期透析血管通路的再建立提供了一条新的思路。展开更多
Objectives:To assess whether the extension of the flushing interval will increase risks of complications associated with totally implantable venous access port(TIVAP)in the off-treatment period.Methods:A retrospective...Objectives:To assess whether the extension of the flushing interval will increase risks of complications associated with totally implantable venous access port(TIVAP)in the off-treatment period.Methods:A retrospective single-center observational study was performed.Patients with a TIVAP in the off-treatment period that underwent regular flushing in our clinic were included.Data concerning patients and their TIVAPs were recorded.Patient baseline characteristics and TIVAP-related complications were analyzed.Continuous variables were analyzed by ANOVA or the Kruskal-Wallis H test.To compare the occurrence of TIVAP-related complications,the chi-square test was used;if needed,Fisher’s exact test was used.Results:Totally 607 patients were reviewed,and 563 patients were finally included.Thirteen complications were recorded,including 11 cases of catheter occlusion(1.95%),one case of port cannula rotation(0.18%),and one case of catheter tip malposition(0.18%).No device-related infection or venous thrombosis was recorded.Among these patients,the average flushing interval was 35.27±13.09 days.Patients were divided into three groups according to the flushing interval:every 28 days or less(Group 1,n=133);every 29-44 days(Group 2,n=350);and every 45 days or more(Group 3,n=80).No significant difference in catheter-related complications was found among the three groups(P>0.05).Conclusions:In the TIVAP off-treatment period,patients without any history of TIVAP-related complications during approximately one year can attempt to prolong the flushing interval to more than 4 weeks;we further suggest that 5-6 weeks may be an appropriate option for these patients.展开更多
文摘BACKGROUND Central venous access is essential for administering chemotherapy in patients with gastrointestinal cancer.Peripherally inserted central catheters(PICC)and totally implantable venous access ports(TIVAP)are widely used,but comparative data regarding their impact on catheter-related complications and quality of life(QoL)remain limited.AIM To evaluate the impact of TIVAPs compared with PICC on catheter-related complications and QoL in patients with gastrointestinal cancer undergoing chemotherapy.METHODS This retrospective study included adults with gastrointestinal cancer who underwent central venous access device insertion for chemotherapy at our institution between December 2021 and December 2024.Inclusion criteria encompassed indications for intermittent intravenous chemotherapy,anticipated treatment duration of≥12 weeks,an adequate preoperative hematologic profile,accessible upper body veins,and complete medical records.Patients were excluded if they had an anticipated survival of less than three months,active systemic infection,severe thrombosis or coagulopathy,communication barriers,or an urgent need for dialysis access.Patients were assigned to either the PICC or TIVAP group based on device type.Data collected included demographic variables,cancer characteristics,insertion procedure details,complications,and QoL,assessed via the EuroQol 5-Dimensions-3 levels,visual analogue scale,and the European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30.RESULTS A total of 346 patients were analyzed.Baseline demographic,clinical,and cancer characteristics were similar between groups.The TIVAP group demonstrated a significantly lower incidence of catheter-related complications than the PICC group,with no pneumothorax occurring in either group.QoL assessments at baseline were comparable.At one month,the TIVAP group exhibited significantly higher EuroQoL Five Dimensions health state scores and QLQ-C30 global health status scores.Multivariate analysis identified TIVAP use,catheter tip placement in the distal superior vena cava/right atrium,prophylactic antibiotic administration,and antimicrobial dressing application as independent protective factors associated with reduced complications and improved QoL.CONCLUSION In patients with gastrointestinal cancer undergoing chemotherapy,TIVAPs are associated with a lower incidence of catheter-related complications and improved QoL than PICCs.Optimal device selection,precise catheter tip positioning,and effective perioperative management are critical for minimizing complications and enhancing patient-reported outcomes during treatment.
文摘Background: As the prognosis of lung cancer (LC) patients improves, subcutaneously implanted central venous access device ports (CV-ports) have frequently been used for continuing chemotherapy (CC) or palliative care (PC). In this study, we examined the clinical course of LC patients with subcutaneously implanted CV-ports from the time of receiving chemotherapy to the endpoint of cancer. Materials and Methods: We retrospectively reviewed the clinical data and treatment history of LC patients with subcutaneously implanted CV-ports between June 2008 and November 2013 using clinical records and a pharmacy database. Results: Of the 132 LC patients with subcutaneously implanted CV-ports, 79 (59.8%) had CV-ports for CC (the CC group) and 53 (40.2%) had CV-ports for PC (the PC group). After CV-port implantation, LC patients in the CC group received a median of two regimens with a median of 6 cycles. The median survival time of patients in the CC and PC groups was 457 and 44 days, respectively. In the CC group, the median survival time of small cell and non-small cell LC patients was 342 (95% confidence interval, 235 - 627) and 563 (95% confidence interval, 368 - 728) days, respectively. Nine patients (6.8%) had their CV-ports removed due to complications. Forty (30.3%) of the 132 enrolled patients were referred for at-home PC. The at-home death rate observed among these 40 patients was 30.0% (N = 12). Conclusion: CV-ports may contribute to seamless oncological care.
文摘目的评估经皮原位隧道式带涤纶套透析导管(tunnel cuffed central venous catheter,TCC)再置入技术的安全性、有效性。方法选取2023年1月─2024年12月四川大学华西医院肾脏内科收治符合条件的存留有原TCC皮下隧道需再次置入导管的血液透析患者。收集患者一般情况、血液透析情况、既往导管使用情况等信息。所有患者均尝试使用原TCC皮下隧道原位再置入导管,如未成功,则再穿刺后重新置入TCC。记录手术技术手段、手术时间、并发症、手术后导管使用情况等信息。结果共纳入53例患者,45例成功使用原皮下隧道置入导管,8例患者再穿刺成功后置入新导管。所有患者均顺利置入导管并使用,经原隧道原位置管成功率84.91%,手术时间较再穿刺置管患者减少(t=5.142,P=0.002)。手术后均无大出血、感染等手术并发症,手术后透析导管血流量为(233.77±17.23)ml/min。结论X线引导下,原位隧道式带涤纶套透析导管的再置入技术具有较高的安全性和有效性,在一定程度上缩短操作时间、降低手术难度,为长期透析血管通路的再建立提供了一条新的思路。
文摘Objectives:To assess whether the extension of the flushing interval will increase risks of complications associated with totally implantable venous access port(TIVAP)in the off-treatment period.Methods:A retrospective single-center observational study was performed.Patients with a TIVAP in the off-treatment period that underwent regular flushing in our clinic were included.Data concerning patients and their TIVAPs were recorded.Patient baseline characteristics and TIVAP-related complications were analyzed.Continuous variables were analyzed by ANOVA or the Kruskal-Wallis H test.To compare the occurrence of TIVAP-related complications,the chi-square test was used;if needed,Fisher’s exact test was used.Results:Totally 607 patients were reviewed,and 563 patients were finally included.Thirteen complications were recorded,including 11 cases of catheter occlusion(1.95%),one case of port cannula rotation(0.18%),and one case of catheter tip malposition(0.18%).No device-related infection or venous thrombosis was recorded.Among these patients,the average flushing interval was 35.27±13.09 days.Patients were divided into three groups according to the flushing interval:every 28 days or less(Group 1,n=133);every 29-44 days(Group 2,n=350);and every 45 days or more(Group 3,n=80).No significant difference in catheter-related complications was found among the three groups(P>0.05).Conclusions:In the TIVAP off-treatment period,patients without any history of TIVAP-related complications during approximately one year can attempt to prolong the flushing interval to more than 4 weeks;we further suggest that 5-6 weeks may be an appropriate option for these patients.
