Key result
A primarily successful surgical approach for totally implantable access ports was associated with a 3% complication rate, compared to 9% when converted to a secondary Seldinger technique.
Why the study?
Does conversion to a Seldinger technique increase complication rates compared to a primarily successful surgical approach for TIAP implantation?
Cohort (n=400)
Does conversion to a Seldinger technique increase complication rates compared to a primarily successful surgical approach for TIAP implantation?
Absolute Event Rate: 3% vs 9%
Conversion from a primary surgical approach to a Seldinger technique for TIAP implantation is associated with a higher complication rate, suggesting a need for improved surgical port placement techniques.
May support preferring primary surgical TIAP success to limit complications; hypothesis-generating pending randomized trials.
BACKGROUND: The objective of this study was to analyze factors that may have an impact on the failure rate of the surgical implantation technique for totally implantable access ports (TIAP) and to assess whether morbidity rates differ between a primarily successful surgical and a secondary Seldinger approach. METHODS: Four hundred consecutive patients receiving a primary TIAP in local anesthesia were included into this retrospective cohort study. A logistic regression-model was used to evaluate reasons for failure of the TIAP method. RESULTS: Three hundred eighteen (79.5%) patients had a successful TIAP procedure, 82 patients were intraoperatively converted to a Seldinger technique. Reasons for failure were: correct positioning impossible n = 54, no or only an undersized vessel for insertion available n = 17, other reasons n = 11. Logistic regression analysis did not reveal any significant factor for failure of the primary surgical approach. In the group with primarily successful TIAP, 8 of 318 patients (3%) developed complications compared to 7 of 82 patients (9%) converted to a Seldinger technique. CONCLUSION: Failure of the surgical approach for implanting totally implantable access ports is related to insertion and positioning. Conversion to a Seldinger technique results in a higher complication rate. A modified approach for surgical port placement should be considered in order to reduce complications.
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Seiler et al. (2005) conducted a cohort in Patients requiring totally implantable access ports (TIAP) (n=400). Primary surgical TIAP approach vs. Intraoperative conversion to a Seldinger technique was evaluated on Complications (morbidity). A primarily successful surgical approach for totally implantable access ports was associated with a 3% complication rate, compared to 9% when converted to a secondary Seldinger technique.
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