Single-centre experience with tunnelled central venous catheters in 150 cancer patients

Tunnelled venous catheters improve venous access in cancer patients, but are associated with complications. We retrospectively analysed the outcome of Hickman catheter and Port-A-Cath (PAC) insertion in cancer patients from a department of medical oncology and compared these results with the literature.

The files of patients in whom insertion of a Hickman or PAC was planned in the period March 1992 to August 1999 were analysed.

In total, 150 files were evaluated. In 149 patients, 128 Hickman catheters and 38 PACs were inserted successfully. Complications occurred in 44.6% of the catheters inserted successfully. Infection (24.1%) and thrombosis (7.2%) were observed most frequently. In 66.7% of patients with thrombosis, the catheter tip was positioned incorrectly. Removal for catheter-related complications occurred in 47.7%. Of 146 catheter insertions for which the name of the responsible (resident) surgeon could be traced, 48 different names were identified.

In comparison with other studies, we found a high incidence of infections and a high removal rate for catheter-related complications. We confirmed the relationship between thrombosis and an inadequate position of the catheter tip. The level of experience of the (resident) surgeon performing the catheter insertion may have played a role in the high complication rate.