[Permanent central venous catheters in oncologic patients]

Permanent central venous catheters play an important role in the treatment of patients with malignancies. Two systems are available, Hickman-Broviac Catheters (HB) and Port-a-Cath (PAC), the latter is fully implantable. Since 1982, the systems have been used in the Finsen Institute. In the period 01.01.1984 to 31.03.1988 a total of 232 HB and 52 PAC were inserted in 245 patients with solid malignant tumours with one exception. All the catheters were inserted with the venous cut-down technique and at the end of the period mainly in local analgesia. The total indwelling time was 36,859 days, mean 99 days (1-616 days) for HB and 92 days (8-519 days) for PAC. Seventeen catheters remained in place for more than 365 days. A total of 114 complications concerning 88 catheters were registered. The most serious complications were sepsis and thrombosis. The frequency of sepsis was low, 0.06 (HB) and 0.01 (PAC) per 100 catheter-days. The corresponding frequency of thrombosis was 0.03/100 catheter-days for both systems. Sixty-one HB and five PAC had to be removed because of complications. In general, the complication rate was lower for the PAC method. In addition, the nursing care was reduced to a minimum. The surgical cut-down method is preferable, as catheter implantation is possible even in patients with disorders of the coagulation system.