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Published on: February 18, 2020
Comparative study of access routes for Port-A-Cath® implantation
Javier Pérez Calvo1, Jordi Castellví Valls1, Oriol Crusellas1
1Servicio de Cirugía General y del Aparato Digestivo, Hospital de Sant Joan Despí Moisses Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, España.
Introduction:
There has been an increase in the implantation of subcutaneous reservoirs in recent years. The objective of this study was to compare puncture techniques against venous dissection.
Methods:
This retrospective cohort study included patients who required a Port-a-Cath and were divided into two groups: venous puncture (PV) and venous dissection (DV). Patients were over 18 years of age, requiring continued intravenous treatment, with no restriction of pathology. Patients with a previous reservoir and <18 years old were excluded. The choice of the technique was based on the surgeon's preferences. We analyzed the clinical parameters of age, sex, ASA, BMI, reason for placement and laterality, and data related to the complications and withdrawal rate in each of the groups.
Results:
386 patients were included for 5 years: 228 DV group and 155 PV group. In three cases, the technique was not documented. There were no differences between the two groups with respect to age, sex, ASA, BMI and reason for implantation (p>0.05). The average follow-up was two years. The DV group was found to have a lower number of complications, while the PV group had an increased incidence of catheter replacement and removal. However, these differences were not statistically significant (p=0.113).
Conclusions:
Both DV and PV are safe and effective techniques. In our experience, DV presented better intraoperative and long-term results. Further studies are recommended to discern which technique to use more safely.
