Central venous port placement: a comparison of axillary versus anterior chest wall placement

To compare morbidity in patients with surgically implanted central venous ports that were placed in the subcutaneous tissues of the mid axillary line at the anterior border of the latissimus muscle (group A) versus the anterior chest wall (group C).

Between 2003 and 2007, a total of 183 patients with breast cancer were taken to the operating room for central venous port placement for delivery of chemotherapy. Port location was determined by patient and surgeon preference. Patient demographics were collected, and complications were evaluated by electronic medical record review. Complications identified included infection, thrombosis, port problems, and catheter problems. Basic descriptive statistics were generated. Patients with axillary ports were then compared to those with chest wall ports by appropriate t-tests or χ(2) tests.

During this period, 137 (75%) of 183 ports were placed in the axillary position. The complication rate was 10% (9% in group A vs. 13% in group C). There were 14 catheter-related complications and 5 port-related complications. There was no statistically significant difference in complications between the two groups (P = 0.45). Patients with axillary ports weighed less (mean 75.8 kg in group A vs. 84.9 kg in group C) and were more likely to have catheters placed in the internal jugular vein (82% in group A vs. 56% in group C).

There is no difference in rate or type of complications between axillary and chest wall port location. Subcutaneous ports can safely be placed in the mid axillary line. Axillary ports spare the patient the negative cosmetic outcomes of chest wall ports.