CERVICOFACIAL CANCER - A PROSPECTIVE-STUD Y OF COMPLICATIONS RELATED TO IMPLANTABLE VENOUS ACCESS SYSTEMS

Objectives: Implantable systems for venous access are widely used in c ervicofacial cancer. We prospectively evaluated complications related to this type of venous access in our cancer patients. Methods: From Se ptember 1991 to September 1993, an implantable system for venous acces s was installed in 164 patients with epidermoid carcinoma of the upper respiratory and digestive tracts. The systems were implanted in the s ubclavian vein by 20 different operators (mean number of implants per operator = 8.2). All catheters mere tunnelized. Chemotherapy was a com bination of 5 fluorouracil and cisplatinium. Results: Immediate compli cations included impossible implantation (n = 12,7.3%), pneumothorax ( n = 5), false passage (n = 4), haematoma (n = 3), arterial puncture (n = 2) and abcess of the thoracic wall (n = 1). During use, complicatio ns included extravasation (n = 4), catheter thrombosis (n = 2), venous thrombosis (n = 2) and infection at the site of implantation, desinse rtion of the catheter from the chamber, haematoma at the site of impla ntation and septicaemia (n = 1 each). The rate of complications was re lated to implantation (17% of the implantations) or to use (8%). Concl usions: The rate of complications due to implantable venous access sys tems is relatively low, suggesting that these systems are acceptable f or ambulatory chemotherapy.