Standardized procedure prevents perioperative and early complications in totally implantable venous-access ports - a complication analysis of more than 1000 TIVAP implantations

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Purpose Since their invention 40 years ago totally implantable venous-access ports (TIVAPs) have become indispensable in cancer treatment. Aim of our study was to analyse complications under standardized operative and perioperative procedures and to identify risk factors for premature port catheter explantation. Methods 1008 consecutive TIVAP implantations were studied for success rate, perioperative, early and late complications. Surgical, clinical and demographic factors were analyzed as potential risk factors for emergency port catheter explantation. Results Successful surgical TIVAP implantation was achieved in 1005/1008 (99.7%) cases. No intra- or perioperative complications occurred. Thirty-two early complications and 88 late complications were observed leading to explantation in 11/32 (34.4%) and 34/88 (38.6%) cases, respectively. The most common complications were infections in 4.7% followed by thrombosis in 3.6%. Parameters that correlated with unplanned TIVAP explantation were gender (port in situ: female 95% vs. male 91%, p = 0.01), underlying disease (breast cancer 97% vs. gastrointestinal 89%, p = 0.004), indication (chemotherapy 95% vs. combination of chemotherapie and parenteral nutrition 64%, p < 0.0001), type of complication (infection 13.4% vs. TIVAP-related complication 54% and thrombosis 95%, p < 0.0001). Conclusion Standardized operative and perioperative TIVAP implantation procedures provide excellent results and low explantation rate.