Öz
Amaç: Bu çalışmanın amacı, tek merkezde santral venöz
portların çıkarılma nedenlerinin sıklıklarını tespit etmek, port kaynaklı enfeksiyon
ile ilişkili risk faktörlerini ve portların açık kaldığı süreyi etkileyen
faktörleri belirlemektir.
Gereç ve Yöntem: Ocak 2005 -
Mayıs 2017 tarihleri arasında port çıkarma işlemi yapılmış 154 hasta çalışmaya
dahil edildi. Hastaların yaş ve cinsiyetleri, klinik tanıları, portlarının
çıkarılma nedenleri, mikrobiyolojik test sonuçları ve portlarının açık kaldığı
süreler retrospektif olarak araştırıldı. Port kaynaklı enfeksiyon ile ilişkili
risk faktörlerini karşılaştırmak için Ki-kare testi, portların açık kaldığı
süreyi etkileyen faktörleri karşılaştırmak için ise Mann-Whitney U testi
kullanıldı.
Bulgular: Hastaların %51.3’ü kadın, %48.7’si erkekti (yaş ortalaması, 55.1±15).
Portların en sık (%53.2) enfeksiyon gerekçesiyle çıkarıldığı tespit edildi. Cinsiyetin,
yaşın, malignite tipinin ve sindirim kanalı kanserine sahip olmanın enfeksiyon
sıklığını anlamlı derecede etkilemediği belirlendi. Enfeksiyon gelişen
hastaların kültürlerinde en sık (%20.9) izole edilen patojenin Staphylococcus aureus olduğu görüldü.
Cinsiyetin, yaşın, malignite tipinin ve sindirim kanalı kanserine sahip olmanın
portların açık kaldığı süreyi anlamlı derecede etkilemediği, buna karşın
enfeksiyonun bu süreyi önemli ölçüde kısalttığı tespit edildi.
Sonuç: Kanser hastalarının yarısından fazlasının portu enfeksiyon nedeniyle
çıkarılmaktadır. Enfeksiyon, portların açık kaldığı süreyi önemli ölçüde
kısaltmaktadır.
Anahtar Kelimeler
Kaynakça
- Ji L, Yang J, Miao J, Shao Q, Cao Y, Li H. Infections related to totally implantable venous-access ports: Long-term experience in one center. Cell Biochem Biophys 2015;72(1):235-40.
- Lebeaux D, Larroque B, Gellen-Dautremer J, et al. Clinical outcome after a totally implantable venous access port-related infection in cancer patients: A prospective study and review of the literature. Medicine 2012;91(6):309-18.
- Biacchi D, Sammartino P, Sibio S, et al. Does the implantation technique for totally implantable venous access ports (TIVAPs) influence long-term outcome? World J Surg 2016;40(2):284-90.
- Kurul S, Saip P, Aydin T. Totally implantable venous-access ports: Local problems and extravasation injury. Lancet Oncol 2002;3(11):684-92.
- Barbetakis N, Asteriou C, Kleontas A, Tsilikas C. Totally implantable central venous access ports. Analysis of 700 cases. J Surg Oncol 2011;104(6):654-6.
- Fischer L, Knebel P, Schröder S, et al. Reasons for explantation of totally implantable access ports: A multivariate analysis of 385 consecutive patients. Ann Surg Oncol 2008;15(4):1124-9.
- Hsieh CC, Weng HH, Huang WS, et al. Analysis of risk factors for central venous port failure in cancer patients. World J Gastroenterol 2009;15(37):4709-14.
- Chang L, Tsai JS, Huang SJ, Shih CC. Evaluation of infectious complications of the implantable venous access system in a general oncologic population. Am J Infect Control 2003;31(1):34-9.
- Hickman RO, Buckner CD, Clift RA, Sanders JE, Stewart P, Thomas ED. A modified right atrial catheter for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 1979;148(6):871-5.
- Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet 1973;136(4):602-6.
- Vidal M, Genillon JP, Forestier E, et al. Outcome of totally implantable venous-access port-related infections. Med Mal Infect 2016;46(1):32-8.
- Schwarz RE, Groeger JS, Coit DG. Subcutaneously implanted central venous access devices in cancer patients: A prospective analysis. Cancer 1997;79(8):1635-40.
- Kock HJ, Pietsch M, Krause U, Wilke H, Eigler FW. Implantable vascular access systems: Experience in 1500 patients with totally implanted central venous port systems. World J Surg 1998;22(1):12-6.
- Shim J, Seo TS, Song MG, et al. Incidence and risk factors of infectious complications related to implantable venous-access ports. Korean J Radiol 2014;15(4):494-500.
- Lebeaux D, Fernández-Hidalgo N, Chauhan A, et al. Management of infections related to totally implantable venous-access ports: challenges and perspectives. Lancet Infect Dis 2014;14(2):146-59.
- Penel N, Neu JC, Clisant S, Hoppe H, Devos P, Yazdanpanah Y. Risk factors for early catheter-related infections in cancer patients. Cancer 2007;110(7):1586-92.
- Vescia S, Baumgärtner AK, Jacobs VR, et al. Management of venous port systems in oncology: A review of current evidence. Ann Oncol 2008;19(1):9-15.
- Groeger JS, Lucas AB, Thaler HT, et al. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 1993;119(12):1168-74.
- Chen WT, Liu TM, Wu SH, Tan TD, Tseng HC, Shih CC. Improving diagnosis of central venous catheter-related bloodstream infection by using differential time to positivity as a hospital-wide approach at a cancer hospital. J Infect 2009;59(5):317-23.
- Aribas BK, Tiken R, Aribas O, et al. Factors on patency periods of subcutaneous central venous port: long-term results of 1.408 patients. Iran J Radiol 2017;14(2):e36816.
Öz
Aim: The aim of this study is to determine the
frequency of reasons for port removal in a single center, to identify the risk factors associated with
port-related infection and the factors that affect the patency period of the
ports.
Materials and Methods:154 patients with port
removal from January 2005 to May 2017 were included in the study. The
characteristics of these patients, their clinical diagnoses, reasons for port
removal, microbiological data and patency periods were retrospectively
investigated. The Chi-square test was used to compare the risk factors
associated with port-related infection, and the Mann-Whitney U test was used to
compare the factors affecting the patency period.
Results: 51.3% of the patients were female, 48.7% were
male (mean age, 55.1±15). The most frequent (53.2%) reason for port removal was
found to be infection. It was determined that gender, age, malignancy type and
having digestive tract cancer did not affect the infection frequency
significantly. The most common pathogen (20.9%) was found to be Staphylococcus aureus in the cultures of infected patients. It was found that gender, age,
malignancy type and having digestive tract cancer did not significantly affect
the patency period of the ports, however, infection significantly shortened
this period.
Conclusion: Ports are removed due to
infection in more than half of the patients with cancer. Infection
significantly shortens the patency period of ports.
Anahtar Kelimeler
Central venous port interventional radiology cancer infection.
Kaynakça
- Ji L, Yang J, Miao J, Shao Q, Cao Y, Li H. Infections related to totally implantable venous-access ports: Long-term experience in one center. Cell Biochem Biophys 2015;72(1):235-40.
- Lebeaux D, Larroque B, Gellen-Dautremer J, et al. Clinical outcome after a totally implantable venous access port-related infection in cancer patients: A prospective study and review of the literature. Medicine 2012;91(6):309-18.
- Biacchi D, Sammartino P, Sibio S, et al. Does the implantation technique for totally implantable venous access ports (TIVAPs) influence long-term outcome? World J Surg 2016;40(2):284-90.
- Kurul S, Saip P, Aydin T. Totally implantable venous-access ports: Local problems and extravasation injury. Lancet Oncol 2002;3(11):684-92.
- Barbetakis N, Asteriou C, Kleontas A, Tsilikas C. Totally implantable central venous access ports. Analysis of 700 cases. J Surg Oncol 2011;104(6):654-6.
- Fischer L, Knebel P, Schröder S, et al. Reasons for explantation of totally implantable access ports: A multivariate analysis of 385 consecutive patients. Ann Surg Oncol 2008;15(4):1124-9.
- Hsieh CC, Weng HH, Huang WS, et al. Analysis of risk factors for central venous port failure in cancer patients. World J Gastroenterol 2009;15(37):4709-14.
- Chang L, Tsai JS, Huang SJ, Shih CC. Evaluation of infectious complications of the implantable venous access system in a general oncologic population. Am J Infect Control 2003;31(1):34-9.
- Hickman RO, Buckner CD, Clift RA, Sanders JE, Stewart P, Thomas ED. A modified right atrial catheter for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 1979;148(6):871-5.
- Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet 1973;136(4):602-6.
- Vidal M, Genillon JP, Forestier E, et al. Outcome of totally implantable venous-access port-related infections. Med Mal Infect 2016;46(1):32-8.
- Schwarz RE, Groeger JS, Coit DG. Subcutaneously implanted central venous access devices in cancer patients: A prospective analysis. Cancer 1997;79(8):1635-40.
- Kock HJ, Pietsch M, Krause U, Wilke H, Eigler FW. Implantable vascular access systems: Experience in 1500 patients with totally implanted central venous port systems. World J Surg 1998;22(1):12-6.
- Shim J, Seo TS, Song MG, et al. Incidence and risk factors of infectious complications related to implantable venous-access ports. Korean J Radiol 2014;15(4):494-500.
- Lebeaux D, Fernández-Hidalgo N, Chauhan A, et al. Management of infections related to totally implantable venous-access ports: challenges and perspectives. Lancet Infect Dis 2014;14(2):146-59.
- Penel N, Neu JC, Clisant S, Hoppe H, Devos P, Yazdanpanah Y. Risk factors for early catheter-related infections in cancer patients. Cancer 2007;110(7):1586-92.
- Vescia S, Baumgärtner AK, Jacobs VR, et al. Management of venous port systems in oncology: A review of current evidence. Ann Oncol 2008;19(1):9-15.
- Groeger JS, Lucas AB, Thaler HT, et al. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 1993;119(12):1168-74.
- Chen WT, Liu TM, Wu SH, Tan TD, Tseng HC, Shih CC. Improving diagnosis of central venous catheter-related bloodstream infection by using differential time to positivity as a hospital-wide approach at a cancer hospital. J Infect 2009;59(5):317-23.
- Aribas BK, Tiken R, Aribas O, et al. Factors on patency periods of subcutaneous central venous port: long-term results of 1.408 patients. Iran J Radiol 2017;14(2):e36816.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 3 Aralık 2018 |
| Gönderilme Tarihi | 16 Ekim 2017 |
| Yayımlandığı Sayı | Yıl 2018 |
Cited By
Determination of nursing practices regarding port catheter care
Journal of Medicine and Palliative Care
https://doi.org/10.47582/jompac.1066519