Ultrasound-guided Port-A-Cath implantation-personal experience of 586 cases

Abstract

Background: The implantation of a Port-A-Cath (PAC) is a common surgical procedure used in cancer patients who need to establish a route for chemotherapy or nutrition. It was usually done under blind percutaneous puncture on neck or chest or direct dissection the subclavian vein or the internal jugular vein in the past. The introduction of ultrasound-guided Port-A-catheter device has provided a simple, permanent and safe access to the vascular system. It greatly improved the quality of life of the cancer patients involved, whose activities, daily hygiene and bodily attractiveness remain practically unrestricted. The purpose of this study was to analyze the success rate, and operation-related and postoperative complications of PAC implantation under ultrasound guidance. Method(s): In this study, patients with a variety of neoplastic diseases or poor nutrition requiring chemotherapy or TPN who were undergoing PAC were studied prospectively over a 28-month period (1 February 2009 to 6 June 2011). 586 cases are enrolled. PAC is placed with ultrasound-guided. Characteristic of patients are recorded during surgery. Follow-up continued until PAC was removed or obstructed or the end of this study. Result(s): The success rate of ultrasound-guided PAC was 100 %. The average time of operation was 33.7 minutes. The average attempt of vessel puncture was 1.2. No major surgery-related complication including hemothorax, hemothorax and great vessel injury was noted in this study. Surgery-related complication occurred in 9(1.5%) implants : 3 malposition and 6 hematoma. Post-operative complication occurred in 13 (2.2%) implants: 6 wound infection and 7 PAC malfunction. Conclusion(s): Port-A-Cath (PAC) with ultrasound-guided is effective to access the vessels with higher success rate and lower surgical complications compared to the conventional landmark method. This study represents that Ultrasound-guided PAC is safe, time-saving and should be routinely used in future medical practice.