Murat DÖKDÖK, Kutlay KARAMAN, Aysen YUCEL

Total İmplante Venöz Erişim Portlarında İnternal Juguler ve Subklavian Ven Yaklaşımlarının Karşılaştırılması

Bu çalışmanın amacı, subklavyan ven (SCV) yaklaşımına karşı ultrason rehberliğinde düşük internal juguler ven (IJV) yaklaşımı ile yerleştirilen tamamen implante edilebilir venöz erişim portlarının (TIVAP'ler) sonuçlarını ve komplikasyonlarını geriye dönük olarak gözden geçirmektir. Kateter çıkarılıncaya veya çalışma süresinin sonuna kadar izlenebilen 304 kanser hastası çalışmaya alındı. 200 hastaya IJV yoluyla TIVAP ve 104 hastaya SCV yoluyla TIVAP yerleştirildi. İstatistiksel analizler hasta özellikleri ve primer malignite bölgesi açısından iki grupta fark olmadığını gösterdi, TIVAP'lerin büyük çoğunluğu sağ tarafa yerleştirilmişti. Ortalama port kalma süresi SCV grubuna kıyasla IJV grubunda daha yüksekti, bu fark istatistiksel olarak anlamlıydı (p<0.001). SCV'de komplikasyonlar IJV yaklaşımına göre daha sıktı (12 hastaya karşı 3 hasta). Çalışmamız, TIVAP'ın uzun süreli kemoterapi uygulaması için güvenli ve etkili bir yol olduğunu ve TIVAP'lerin doğru IJV yoluyla yerleştirilmesinin düşük uzun dönem komplikasyon oranı ile ilişkili olduğunu ortaya koydu.

Anahtar Kelimeler:

Kanser, Venöz Erişim Portları, Venöz Kateterizasyon

A Comparison of Internal Jugular versus Subclavian Vein Approaches in Totally Implanted Venous Access Ports

The purpose of this study was to retrospectively review the outcome and complications of totally implantable venous-access ports (TIVAPs) inserted via low internal jugular vein (IJV) approach under ultrasound guidance versus subclavian vein (SCV) approach.304 cancer patients who could be followed up to the time of catheter removal or to the end of the study period were enrolled in the study. 200patients had the placement of TIVAPs via IJV and 104 patients via SCV. Statistical analysis showed that there were no differences with regard to the patient characteristics and to the site of primary malignancy in two groups, while the large majority of the TIVAPs had been inserted in the right side. The average port dwelling time was higher in the IJV group compared to the SCV group, the difference was statistically significant (p<0.001). Complications were more frequent in the SCV than in the IJV approach (12 patients vs. 3 patients). Our analysis revealed that TIVAP is a safe and effective route for long-term administration of chemotherapy, and the placement of TIVAPs via the right IJV is associated with a low long-term complication rate.

Keywords:

Cancer, Venous Access Ports, Venous Catheterization,

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