ADVANTAGES OF PORT-SYSTEMS COMPARED WITH VARIOUS METHODS OF LONG-TERM VENOUS ACCESS IN ONCOLOGY

  • O. P. Kolesnik Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
  • A. V. Kadzhoian Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
  • S. M. Machuskhiy Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
  • K. O. Bolshakova Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
  • D. Ye. Cherniavskiy Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
Keywords: access, port-system, catheter, implantation

Abstract

The issue of providing reliable, safe and at the same time least invasive venous access remains one of the topical issues of oncology. Installation of venous access for patients with oncological pathology is necessary for chemotherapy, blood sampling for analysis, as well as for palliative and symptomatic care for patients which has advanced stages of malignant process. Therapeutic agents can be administered in various ways: intra-arterially, intravenously, intraperitoneally. In the world of modern medicine, intravenous administration of drugs is most often used, since it provides a high rate of spread, as well as systemic action in the human body. However, not all medicinal substances are amenable to easy and safe delivery by parenteral route and, first of all, it concerns cytostatic agents. Chemotherapy has an irritating and sometimes damaging effect on the walls of peripheral vessels, and frequent blood fetuses and the introduction of parenteral chemotherapeutic agents entail complications in the form of phlebitis, thrombophlebitis and other septic processes that can lead to death. Despite the fact that the port system was invented more than 50 years ago, this device is increasingly used in the daily clinical practice of an oncologist and doctors of other specialties, including anesthesiology and pediatrics. So the port system is a small device which is placed under the skin under local anesthesia to perform certain medical manipulations related to the treatment and diagnosis of diseases. This article provides arguments on the appropriateness of using the subcutaneous venous port system, its advantages, disadvantages, as well as the features of its installation, exploitation and also their importance in the modern clinical medicine.

References

1. Biffi R, Orsi F, Pozzi S, Pace U, Bonomo G, Monfardini L, Della Vigna P. et al. Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial. Annals of Oncology. 2009;20(5):935-940. doi: 10.1093/annonc/mdn701
2. Chabner B, Roberts T. Chemotherapy and the war on cancer. Nature Reviews Cancer. 2005; (5):65–72. doi: 10.1038/nrc1529
3. Raaf J. Results From Use of 826 Vascular Access Devices in Cancer Patients. Cancer. 1985;(55):1312-1321. doi: https://doi.org/10.1002/1097-0142(19850315)55:6<1312::AID-CNCR2820550626>3.0.CO;2-9
4. Bishop L, Dougherty L, Bodenham A, Mansi J, Crowe P. Guidelines on the insertion and management of central venous access devices in adults. International journal of laboratory hematology. 2007;29(4):261-278. doi: 10.1111/j.1751-553x.2007.00931.x
5. Gallieni M, Pittiruti M, Biffi R. Vascular access in oncology patients. CA: a cancer journal for clinicians. 2008;58(6):319 372. doi: https://doi.org/10.3322/CA.2008.0015
6. Thomas J, MacArthur R, Pierce G, Hermreck A. Hickman-Broviac catheters: indications and results. The American Journal of surgery. 1980;140(6):791-796. doi: 10.1016/0002-9610(80)90119-1
7. O’Grady N, Alexander M, Dellinger E, Gerberding L et al. Guidelines for the Prevention of Intravascular Catheter–Related Infections. Infection control and hospital epidemiology. 2002;23(12):759-769. doi: 10.1086/502007
8. Paleczny J, Banyś-Jafernik B, Gazurek K, Kierpieć K et al. Long-term totally implantable venous access port systems — one center experience. Anaesthesiology Intensive Therapy. 2013;45(4):215-222. doi: 10.5603/ait.2013.0042
9. Bykkulova D, Zablotskiy D, Yershova O et al. Prophylaxis of catheter-associated blood flow infections and care of the central venous catheter (CVC) [Profilaktyka kateter-assotsyirovannyh infektsyi krovotoka I uhod za tsentralnym venoznym kateterom]. Federal Clinical Recommendations. 2014;1-20. Режим доступа: http://www.komi-aids.ru/upload/iblock/35d/35d0813916bfa3ec1a2bed6572e1c855.pdf
10. Sandrucci S, Mussa B et al. Peripherally Inserted Central Venous Catheters. Canadian Journal of Anesthesia. 2015;62(5):560-561. doi: https://doi.org/10.1007/s12630-015-0312-4
11. Tsepenshchikov L, Lyadov V. Periferichesky implantiruyemyi tsentralnyi venosnyi cateter: obzor literatury [Peripherally implanted central venous catheter: a literature review]. 2014;7(2): 221-227. Режим доступа: http://cyberleninka.ru/article/n/perifericheski-implantiruemyy-tsentralnyy-venoznyy-kateter-obzor-literatury
12. Vescia S, Baumgärtner A, Jacobs V et al. Management of venous port systems in oncology: a review of current evidence. Annals of Oncology. 2007;19(1):9-15. doi: 10.1093/annonc/mdm272
13. Keum D, Kim J, Chae M. Safety of a Totally Implantable Central Venous Port System with Percutaneous Subclavian Vein Access. Korean Journal of Thoracic and Cardiovascular Surgery. 2013;46(3):202-207. doi: 10.5090/kjtcs.2013.46.3.202
14. Meshcheriakov A, Buideniuk Yu. Novye metody vvedenenia protiviopukholevykh lekarstvennykh sredstv [New methods of administration of antitumor drugs]. Emergency medicine. 2010;2(27):12-18. Режим доступа: http://www.mif-ua.com/archive/article/12860
15. Woodburn R, inventor. Subcutaneous venous access device and needle system. USA patent, no. US4861341A, 1988.
16. Huber R, inventor. Hypodermic needle. USA patent, no. US2409979A, 1946.
17. Rykov M, Polyakov V. Evoliutsia venoznogo dostupa: vsio yeshche v kruge pervom? [Evolution of venous access: still in the first circle?]. Onkopediatria. 2014;(2):2-5. Режим доступа: http://cyberleninka.ru/article/n/evolyutsiya-venoznogo-dostupa-vse-esche-v-kruge-pervom
18. Teichgräber U, Pfitzmann R, Hofmann H. Central Venous Port Systems as an Integral Part of Chemotherapy. Deutsches Ärzteblatt International. 2011;108(9):147-154. doi: 10.3238/arztebl.2011.0147
19. Clinical Excellence Commission NSW Health. Central Venous Access Device Insertion and Post Insertion Care. 2011; 4-20. Retrieved from: http://www0.health.nsw.gov.au/policies/pd/2011/pdf/PD2011_060.pdf
20. Inoue Y, Kusunoki M. Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review. Surgery Today. 2013;44(8):1406-1414. doi: 10.1007/s00595-013-0672-8
21. Heo B, Pyeon T, Lee H et al. Epidural Infusion of Morphine and Levobupivacaine through a Subcutaneous Port for Cancer Pain Management. The Korean Journal of Pain. 2014;27(2):140-143. doi: 10.3344/kjp.2014.27.2.139
22. Pfeifle C, Howell S, Markman M et al. Totally implantable system for peritoneal access. Journal of Clinical Oncology. 1984;2(11):1277-1280. doi: 10.1200/jco.1984.2.11.1277
23. Davidson S, Rubin S, Markman M et al. lntraperitoneal Chemotherapy: Analysis of Complications with an Implanted Subcutaneous Port and Catheter System. Gynecologic oncology. 1991;41(2):101-106. doi: 10.1016/0090-8258(91)90266-8
24. De Sousa S, Myers P, Bouclier B, Dietrich P et al. Management of malignant pleural effusion and ascites by a triple access multi perforated large diameter catheter port system. World Journal of Surgical Oncology. 2008;6(1):1-4. doi: 10.1186/1477-7819-6-85
25. Shoji T, Tanaka F, Yanagihara K, Inui K, Wada H. Phase II study of repeated intrapleural chemotherapy using implantable access system for management of malignant pleural effusion. Chest. 2002;121(3):821-824. doi: 10.1378/chest.121.3.821
26. Seiler C, Frohlich B, Dorsam U, Kienle P et al. Surgical Technique for Totally Implantable Access Ports (TIAP) Needs Improvement: A Multivariate Analysis of 400 Patients. Journal of Surgical Oncology. 2005;93(1):24-29. doi: 10.1002/jso.20410
27. Knebel P, Fischer L, Huesing J et al. Randomized clinical trial of a modified Seldinger technique for open central venous cannulation for implantable access devices. British Journal of Surgery. 2009;96(2):159-165. doi: 10.1002/bjs.6457
28. Lorch H, Zwaan M, Kagel C, Weiss H. Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovascular and Interventional Radiology. 2001;24(3):180-184. doi: 10.1007/s002700001721
29. Di Carlo I, Pulvirenti E, Mannino M, Toro A. Increased Use of Percutaneous Technique for Totally Implantable Venous Access Devices. Is It Real Progress? A 27-Year Comprehensive Review on Early Complications. Annals of Surgical Oncology. 2010;17(6):1649-1656. doi: 10.1245/s10434-010-1005-4
30. Knebel P, Fischer L, Huesing J, Hennes R, Büchler M, Seiler C. Randomized clinical trial of a modified Seldinger technique for open central venous cannulation for implantable access devices. The British Journal of Surgery. 2009;96(2):159-165. doi: 10.1002/bjs.6457
31. Nocito A, Wildi S, Rufibach K, Clavien P, Weber M. Randomized clinical trial comparing venous cutdown with the Seldinger technique for placement of implantable venous access ports. British Journal of Surgery. 2009;96(10):1129-1134. doi: 10.1002/bjs.6730
32. Marcy P-Y, Magne N, Castadot P, Bailet C, Macchiavello J-C, Namer M, Gallard J-C. Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patients. Breast Cancer Research and Treatment. 2005;92(1):61-67. doi: 10.1007/s10549-005-1711-y
33. Povoski S. A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients. Annals of Surgical Oncology. 2000;7(7):496-502. doi: 10.1007/s10434-000-0496-9
34. Pittiruti M, Malerba M, Carriero C, Tazza L et al. Which is the easiest and safest technique for central venous access? A retrospective survey of more than 5,400 cases. The Journal of Vascular Access. 2000;1(3):100 107. doi: 10.1177/112972980000100306
35. Di Carlo I, Barbagallo F, Toro A, Sofia M, Lombardo R, Cordio S. External jugular vein cutdown approach, as a useful alternative, supports the choice of the cephalic vein for totally implantable access device placement. Annals of Surgical Oncology. 2005;12(7):570-573. doi: 10.1245/aso.2005.04.028
36. Povoski S. External jugular vein cutdown approach for chronic indwelling central venous access in cancer patients: A potentially useful alternative. World Journal of Surgical Oncology. 2004;2(7). doi: 10.1186/1477-7819-2-7
37. Randolph A, Cook D, Gonzales C, Pribble C. Ultrasound guidance forplacement of central venous catheters: a meta-analysis of the literature. Critical Care Medicine. 1996;24(12):2053-2058. doi: 10.1097/00003246-199612000-00020
38. Gibbs F, Murphy M. Ultrasound Guidance for central venous catheters placement. Hospital Physician. 2006;23-31. Retrieved from: http://www.turner-white.com/memberfile.php?PubCode=hp_mar06_venous.pdf
39. Schummer W, Sakka S, Hüttemann E, Reinhart K, Schummer C. Ultrasound guidance for placement control of central venous catheterization. Survey of 802 anesthesia departments for 2007 in Germany. Der Anaesthesist. 2009;58(7):677-685. doi: 10.1007/s00101-009-1569-1
40. Rykov M, Kyrilova O, Polyakov V. Rol luchevykh metodov diagnostiky v obespechenii venoznogo dostupa [The role of radiation diagnostic methods in providing venous access]. Onkopediatria. 2015;2(1):7-15. Режим доступа: http://cyberleninka.ru/article/n/rol-luchevyh-metodov-diagnostiki-v-obespechenii-venoznogo-dostupa
41. Fursova L. Trombozy tserebralnykh ven i sinusov [Thrombosis of cerebral veins and sinuses]. ARS MEDICA. 2009;13(3):106-118. Режим доступа: http://belmapo.by/downloads/neurology/2012/trombozi.pdf
42. Morris S, Jaques P, Mauro M. Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology. 1994;184(1):149-151. doi: 10.1148/radiology.184.1.1609072
43. Sakamoto N, Arai Y, Takeuchi Y, Takahashi M, Tsurusaki M, Sugimura K. Ultrasound-Guided Radiological Placement of Central Venous Port via the Subclavian Vein: A Retrospective Analysis of 500 Cases at a Single Institute. Cardiovascular and Intervention Radiology. 2010;33(5):989-994. doi: 10.1007/s00270-010-9841-y
44. Wirsing M, Schummer C, Neumann R, Steenbeck J, Schmidt P, Schummer W. Is Traditional Reading of the Bedside Chest Radiograph Appropriate To Detect Intraatrial Central Venous Catheter Position? Chest. 2008;134(3):527-533. doi: 10.1378/chest.07-2687
45. Engelhardt W, Sold M, Helzel M. ECG-controlled placement of central venous catheters in patients with atrial fibrillation. Der Anaesthesist. 1989;38(9):476-479. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/2589630
46. Tsygankov V, Zuyevskaia Y, Yegorov Y. K voprosu ispolzovania elektrokardiografii dlia opredeleniia polozhenia kontsa katetera v verkhnei poloi vene [To the question of using electrocardiography to determine the position of the margin of the catheter in the upper hollow vein]. Vestnik Rossiiskogo universiteta druzhby narodov. 2001;81-85. Режим доступа: http://www.fesmu.ru/elib/Article.aspx?id=55972
47. Gebhard R, Szmuk P, Pivalizza E et al. The accuracy of electrocardiogram-controlled central line placement. Anesthesia & Analgesia. 2007;104(1):65-70. doi: 10.1213/01.ane.0000250224.02440.fe
48. Rasulov R, Zubkov R. Polnostiu implantiruemye sistemy dlia venoznogo dostupa: analiz oslozhneniy [Fully implantable systems for venous access: analysis of complications]. Sibirskiy medicinskiy zhurnal. 2013;118(3):105-108. Режим доступа: http://cyberleninka.ru/article/n/polnostyu-implantiruemye-sistemy-dlya-venoznogo-dostupa-analiz-oslozhneniy
49. Maury E, Guglielminotti J, Alzieu M, Guidet B, Offenstadt G. Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion? American Journal of Respiratory and Critical Care Medicine. 2001;164(3):403-405. doi: 10.1164/ajrccm.164.3.2009042
50. Arzu G, Coccolini F, Rossi M, Longaretti F, Costanzi A et al. An entirely echo-guided technique for totally implantable access port positioning. Indian Journal of Surgery. 2012;76(3):204-206. doi: 10.1007/s12262-012-0692-4
51. Rouzrokh M, Shahin Shamsian B, Tabari A, Mahmoodi M et al. Totally Implantable Subpectoral vs. Subcutaneous Port Systems in Children with Malignant Diseases. Archives of Iranian Medicine. 2009;12(4):389-394. PMID:19566357
52. Ma L, Liu Y, Wang J, Chang Y, Yu L, Geng C. Totally implantable venous access port systems and associated complications: A single-institution retrospective analysis of 2,996 breast cancer patients. Molecular and Clinical Oncology. 2016;4(3):456-460. doi: 10.3892/mco.2016.726
53. Paleczny J, Banyś-Jafernik B, Gazurek K, Kierpieć K, Szczerba H, Zipser P. Long-term totally implantable venous access port systems — one center experience. Anaesthesiology Intensive Therapy. 2014;45(4):215-222. doi: 10.5603/AIT.2013.0042
54. Granic M, Zdravkovic D, Krstajic S, Kostic S, Simic A et al. Totally implantable central venous catheters of the port-a-cath type: complications due to its use in the treatment of cancer patients. Journal of B.U.ON.2014;19(3):842-846. PMID:25261677
55. Di Carlo I, Cordio S, La Greca G et al. Totally Implantable Venous Access Devices Implanted Surgically — A Retrospective Study on Early and Late Complications. Archives of Surgery. 2001; 136(9):1050-1053. doi: 10.1001/archsurg.136.9.1050
56. Ignatov A, Hoffman O, Smith B, Fahlke J et al. An 11-year retrospective study of totally implanted central venous access ports: complications and patient satisfaction. European Journal of Surgical Oncology. 2009;35(3):241-246. doi: 10.1016/j.ejso.2008.01.020
57. Babu R, Spicer R. Implanted vascular access devices (ports) in children: complications and their prevention. Pediatric surgery international. 2002;18(1):50-53. doi: 10.1007/s003830200011
58. Yildizeli B, Lacin T, Batirel H et al. Complications and management of long-term central venous access catheters and ports. The Journal of Vascular Access. 2004;5(4):174-178. doi: 10.1177/112972980400500407
59. Yurkin A, Novitskiy A, Tyrenko V, Shchegolev A, Gornostaev D. Osobennosti kateter-assotsyirovannych infektsyi u bolnych zlokachestvennymi limfomami [Features of catheter-associated infections in patients with malignant lymphomas]. Biomedicinskyi zhurnal Medline.ru. 2011;12(49):588-597. Режим доступа: http://www.medline.ru/public/pdf/12_049.pdf
60. Rykov M, Susuleva N, Gyokova Y, Polyakov V. Profilaktika kateter-assotsyirovannych infektsyi v onkopediatrii [Prevention of catheter-associated infections in oncopediatrics]. Zlokachestvennye opucholi. 2013;(2):71-80. Режим доступа: http://www.medline.ru/public/pdf/12_049.pdf
61. Betjes M, van Agteren M. Prevention of dialysis catheter related sepsis with a citrate-taurolidine-containing lock solution. Nephrology Dialysis Tansplantation. 2004;19(6):1546-1551. doi: 10.1093/ndt/gfh014
62. Fazeny-Dörner B, Wenzel C, Berzlanovich A. Central venous catheter pinch-off and fracture: recognition, prevention and management. Bone Marrow Transplantation. 2003;31(10):927-930. doi: 10.1038/sj.bmt.1704022
63. Grigorieva N, Ulanova A, Pyatkov V, Turabov Y. Otryv distalnogo kontsa katetera I migratsia yego po sosudistomu ruslu v protsesse ekspluatatsii polnostiu implantiruiemogo ustroistva (venoznoi port-sistemy) u rebionka s ostrym limfoblastnym leikozom (sluchai iz praktiki) [Detachment of the distal end of the catheter and its migration along the vases during the expluatation of a fully implanted device (venous port system) in a child with acute lymphoblastic leukemia (case from practice)]. Rossyiskyi zhurnal detskoi gematologii I onkologii. 2015;(2): 93-98. Режим доступа: http://nodgo.abvpress.ru/jour/article/view/108. doi: 10.17650/2311-1267-2015-2-2-93-98
64. Burbridge B. Catheter Fracture and Embolization Related to an Arm Venous Port. Case Reports in Radiology. 2011;1-3. doi: 10.1155/2011/763284
65. McGee D, Gould M. Preventing complications of central venous catheterization. The New England Journal of Medicine. 2003;348(26):2684-2686. doi: 10.1056/nejm200306263482615
66. Zaporozhets T. Dogliad za khvorym z implantovanoiu sistemoiu postyinogo venoznogo dostupu (portom) ta vykonannia medychnych manipuliatsyi [Care for a patient with an implanted system of permanent venous access (port) and performing medical manipulations]. Medsestrynstvo: naukovo-praktychnyi zhurnal. 2015;(1):23-28. Режим доступу: https://www.researchgate.net/publication/291956434_doglad_za_hvorim_z_implantovanou_sistemou_postijnogo_venoznogo_dostupu_portom_ta_vikonanna_medicnih_manipulacij.
Published
2020-10-05
How to Cite
O. P. Kolesnik, A. V. Kadzhoian, S. M. Machuskhiy, K. O. Bolshakova, & D. Ye. Cherniavskiy. (2020). ADVANTAGES OF PORT-SYSTEMS COMPARED WITH VARIOUS METHODS OF LONG-TERM VENOUS ACCESS IN ONCOLOGY. Eastern Ukrainian Medical Journal, 6(4), 346-358. Retrieved from https://eumj.med.sumdu.edu.ua/index.php/journal/article/view/102