Use of a peripherally implanted subcutaneous permanent central venous access device for chemotherapy - the Singapore General Hospital experience

Background: Venous access for chemotherapy patients at the Singapore Genera l Hospital has conventionally been via an externalised (Hickman) catheter. A peripherally implanted permanent subcutaneous central venous access devic e (P.A.S.Port) was introduced in 1996. Aims: We review its use, complications and cost competitiveness with other chemotherapy delivery systems. Methods: A retrospective study of clinical records was conducted with fello w up interviews of patients and nursing staff. Results: Twelve patients had the P.A.S.Port inserted for administration of chemotherapy as an outpatient procedure. Immediate complications were pain (8%) and bruising (8%). One port-related infection (8%) one week following insertion was reported and one patient complained of interference with elbo w movement as a late complication. Cost analysis was favourable for P.A.S.P ort over an externalised Hickman catheter or chest-placed port at one year. Patient and nursing staff acceptance was high. Conclusion: P.A.S.Port insertion is a safe outpatient procedure and is an a lternative for permanent venous access.