[Cervicofacial cancerology: complications of implantable systems of venous access. Prospective study]

Implantable systems for venous access are widely used in cervicofacial cancer. We prospectively evaluated complications related to this type of venous access in our cancer patients.

From September 1991 to September 1993, an implantable system for venous access was installed in 164 patients with epidermoid carcinoma of the upper respiratory and digestive tracts. The systems were implanted in the subclavian vein by 20 different operators (mean number of implants per operator = 8.2). All catheters were tunnelized. Chemotherapy was a combination of 5 fluorouracil and cisplatinum.

Immediate complications included impossible implantation (n = 12, 7.3%), pneumothorax (n = 5), false passage (n = 4), haematoma (n = 3), arterial puncture (n = 2) and abscess of the thoracic wall (n = 1). During use, complications included extravasation (n = 4), catheter thrombosis (n = 2), venous thrombosis (n = 2) and infection at the site of implantation, desinsertion of the catheter from the chamber, haematoma at the site of implantation and septicaemia (n = 1 each). The rate of complications was related to implantation (17% of the implantations) or to use (8%).

The rate of complications due to implantable venous access systems is relatively low, suggesting that these systems are acceptable for ambulatory chemotherapy.