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Hemish Kania

Hemish Kania is working as surgical Oncology Fellow at Dr. B. Borooah Cancer Institute, India.

Title: Chemo port insertion without image guidance via. Rt IJV: A single center experience on periprocedural complications

Biography

Biography: Hemish Kania

Abstract

Aim: To report our early experience in chemo port insertion without image guidance by surgeons.

Methods: This was a cross-sectional study conducted in a tertiary center with 19 chemo port insertions done from November 2017 to May 2018. The chemo ports were inserted at the operation theater unit. All the chemo ports had right Internal Jugular Vein (IJV) as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava were not used. Immediate and early complications were recorded. None of the port insertions were performed under image guidance with the aid of ultrasound and fluoroscopy.

Results: The technical success rate was 100%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. No case of early complications was recorded. The most common early complication was catheter blockage (2/19; 10.52%), followed by catheter-related infection (2/19; 10.52%). No incidence of catheter malposition, venous thrombosis and catheter dislodgement or leak was recorded. A total of 1 (5.26%) chemo ports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the chemo port catheter placements via. image guidance in comparison to the one done without image guidance.

Conclusion: Chemo port insertion without image guidance by surgeons gives low periprocedural complication rates in comparison to chemo port insertion done by image guidance. Using right IJV as the entry site, the image guidance gives good success rate with least complication. The advantage of doing it without image guidance is that it saves a lot of time. Also, it can be done under local anesthesia. It doesn’t require any radiological assistance during the procedure. And it requires lesser number of skilled personals in terms of manpower. To our best knowledge, this is the first publication of chemo port insertion without image guidance.