Edogawa Hospital, Japan
Hiroshi Osawa is a faculty of Department of Oncology and Hematology in Edogawa Hospital Tokyo, Japan. He graduated the Teikyo University School of Medicine in 1990. He got his degree in Oncology and Hematology, & Medicine Doctor's degree at the Tokyo Jikei University. He had learned clinical research and molecular biology at Cancer Institute Hospital (4 yrs) and researched resistance in TGF-β I correlates with aberrant expression of TGF-β receptor II in human B-cell lymphoma cell line at National Institute on Aging (3.5 yrs) as a research fellow, Baltimore, USA. Currently, he has been focusing clinical studies and research on gastrointestinal tract field.
Regardless of the fact that we often perform totally implantable venous-access ports (TIVAPs) for cancer chemotherapy, there have been several reports regarding complications. The objective of this study was to summarize the TIVAPs idiopathic complications of 400 devices in latest 6 years. The patients underwent TIVAPs in the internal jugular or sub-clavian vein via the Seldinger technique in our hospital. We used two different devices, which were the Bard X-Port™, used from 2009 to 2012, and the Power Port™ used from 2012 to 2015. These devices are composed of titanium and silicone rubber port (DomePort™, Bard Inc, Salt Lake City, UT, USA) connected to an 8Fr silastic Groshong™ catheter tube. 400 TIVAPs, total 89,568 days insertion, with a median follow up of 405 days. There were 30 idiopathic complications. The complications consisted of eleven complete occlusions (2.8%), eight pocket infections (2%), three of pneumothorax (0.8%), two pinch-offs and slip-offs due to pedunculated breast (0.5%), one catheter-related bacteremia, rubber port disconnection, rubber port rotation in pocket and wound dehiscence due to bevacizumab™(0.3%). Here, we focus to present the complete occlusion. Although, complete occlusion was most popular idiopathic complication of TIVAPs in this study, one patient has undergone complete occlusion with Trousseau syndrome. When we removed TIVAPs, we experimented 12 cm length red thrombus and elevated D-dimer which possibility triggered Trousseau syndrome in parallel. Finally, these complications were found by nurses, who are important in cancer nursing care.