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Surgical technique for totally implantable access ports (TIAP) needs improvement: A multivariate analysis of 400 patients
Author(s) -
Seiler Christoph M.,
Frohlich Boris E.,
Dorsam Ulrich J.,
Kienle Peter,
Buchler Markus W.,
Knaebel HannsPeter
Publication year - 2005
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20410
Subject(s) - medicine , seldinger technique , surgery , logistic regression , retrospective cohort study , complication , cohort , cohort study , port (circuit theory) , catheter , electrical engineering , engineering
Abstract Background The objective of this study was to analyze factors that may have an impact on the failure rate of the surgical implantation technique for totally implantable access ports (TIAP) and to assess whether morbidity rates differ between a primarily successful surgical and a secondary Seldinger approach. Methods Four hundred consecutive patients receiving a primary TIAP in local anesthesia were included into this retrospective cohort study. A logistic regression‐model was used to evaluate reasons for failure of the TIAP method. Results Three hundred eighteen (79.5%) patients had a successful TIAP procedure, 82 patients were intraoperatively converted to a Seldinger technique. Reasons for failure were: correct positioning impossible n = 54, no or only an undersized vessel for insertion available n = 17, other reasons n = 11. Logistic regression analysis did not reveal any significant factor for failure of the primary surgical approach. In the group with primarily successful TIAP, 8 of 318 patients (3%) developed complications compared to 7 of 82 patients (9%) converted to a Seldinger technique. Conclusion Failure of the surgical approach for implanting totally implantable access ports is related to insertion and positioning. Conversion to a Seldinger technique results in a higher complication rate. A modified approach for surgical port placement should be considered in order to reduce complications. J. Surg. Oncol. 2006;93:24–29. © 2005 Wiley‐Liss, Inc.