COMPLICATIONS OF VENOUS ACCESS PORTS IN 132 PATIENTS WITH DISSEMINATED TESTICULAR CANCER TREATED WITH POLYCHEMOTHERAPY

Purpose: Venous access ports (VAPs) con be used to administer polychem otherapy to patients with malignancies, The purpose of this study was to evaluate perioperative and late complications related to VAP implan tations and to analyze factors that may predict the development of com plications. Patients and Methods: During the period 1983 to 1994, 135 VAPs were implanted in 132 patients with disseminated testicular tumor s. In a retrospective study, the perioperative and late complications were recorded in this homogeneous patient group, Multivariate analysis was performed to detect factors that may predict the development of c omplications. Results: The median age of the patients was 28 years (ra nge, 16 to 55). Perioperative complications were recorded in five pati ents (3.7%): pneumothorax in two (1.5%), blood loss in two (1.5%), and mediastinal bleeding in one (0.7%). The ports remained in situ for a total of 55,247 days (median, 413; range, 7 to 1,607). In 31 patients (23%), 42 late complications developed (31%): system obstruction in 13 (9.6%), thrombosis in 11 (8.1%), infection in six (4.4%), catheter de fect in six (4.4%), extravasation in four (3.0%), and local skin necro sis in two (1.5%). Late complications were significantly more common i n patients who had received chemotherapy before VAP implantation (P <. 001). Univariate analysis showed that there were significantly more co mplications after VAP implantation under local anesthesia than under g eneral anesthesia (P <.05). Conclusion: Polychemotherapy could be admi nistered in an adequate manner using a VAP, Complications occurred in 26.7% of a homogeneous group of patients who received a VAP implantati on for polychemotherapy for disseminated testicular cancer. Chemothera py treatment before VAP implantation was the only independent risk fac tor For late complications. (C) 1996 by American Society of Clinical O ncology.