Standardized procedure prevents perioperative and early complications in totally implantable venous-access ports—a complication analysis of more than 1000 TIVAP implantations

• Published in: Langenbeck's archives of surgery 2022-12, Vol.407 (8), p.3755-3762
• Main Authors: Thiel, Karolin, Kalmbach, Sarah, Maier, Gerhard, Wichmann, Dörte, Schenk, Martin, Königsrainer, Alfred, Thiel, Christian
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Cardiac Surgery; General Surgery; Medicine; Medicine & Public Health; Thoracic Surgery; Traumatic Surgery; Vascular Surgery
• ISSN: 1435-2451; 1435-2443; 1435-2451
• DOI: 10.1007/s00423-022-02656-9

Purpose Since their invention 40 years ago, totally implantable venous-access ports (TIVAPs) have become indispensable in cancer treatment. The aim of our study was to analyze complications under standardized operative and perioperative procedures and to identify risk factors for premature port catheter explantation. Methods A total of 1008 consecutive TIVAP implantations were studied for success rate, perioperative, early, and late complications. Surgical, clinical, and demographic factors were analyzed as potential risk factors for emergency port catheter explantation. Results Successful surgical TIVAP implantation was achieved in 1005/1008 (99.7%) cases. No intraoperative or perioperative complications occurred. A total of 32 early complications and 88 late complications were observed leading to explantation in 11/32 (34.4%) and 34/88 (38.6%) cases, respectively. The most common complications were infections in 4.7% followed by thrombosis in 3.6%. Parameters that correlated with unplanned TIVAP explantation were gender (port in situ: female 95% vs. male 91%, p  = 0.01), underlying disease (breast cancer 97% vs. gastrointestinal 89%, p  = 0.004), indication (chemotherapy 95% vs. combination of chemotherapy and parenteral nutrition 64%, p