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Reasons for Explantation of Totally Implantable Access Ports: A Multivariate Analysis of 385 Consecutive Patients

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The objective of this study was to analyze factors leading to explantation of totally implanted access ports (TIAPs) and to assess its occurrence and clinical relevance.

Methods

Of 438 patient consecutive patients with a port explantation, 385 were eligible for this retrospective cohort study. Reasons for explantation as well as demographic, clinical, and surgical characteristics were analyzed by univariate and multivariate models.

Results

The diagnoses leading to TIAP implantation were hematological malignancies in 142 patients (36.8%), breast cancer in 103 patients (26.8%), gastrointestinal cancer in 76 patients (19.8%), nonmalignant diseases in 46 patients (11.9%), and other malignant diseases in 18 patients (4.7%). The reasons for TIAP explantation were infection in 178 patients (46.2%), end of treatment in 129 patients (33.5%), thrombosis in 44 patients (11.4%), TIAP dysfunction in 22 patients (5.7%), and other reasons in 12 patients (3.2%). At the time of TIAP explantation, 115 patients (29.9%) were receiving chemotherapy, and 49 patients (12.7%) were considered immunocompromised. In case of TIAP explantation due to infection, the median length of TIAP in situ time was 303.3 days, whereas the cumulative 10-day and 30-day explantation rates were 2.8% and 10.6%, respectively. By multivariate models, TIAP explantation due to infection is statistically significantly decreased in patients with breast cancer (P < .01) but significantly increased in patients with recurrent TIAP implantation and with ongoing chemotherapy (P < .01).

Conclusions

TIAP explantations are caused primarily by late-term complications, mainly infections. The subsequent interruption of ongoing treatment makes further efforts necessary to reduce such complications.

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ACKNOWLEDGMENT

This study was sponsored in part by Vygon GmbH & Co. KG, Germany.

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Authors and Affiliations

  1. Department of General, Visceral and Trauma Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany

    Lars Fischer MD, Phillip Knebel MD, Steffen Schröder MS, Markus K. Diener MD, Roland Hennes MD, Klaus Buhl MD, Bruno Schmied MD & Christoph M. Seiler MD

  2. Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, D-69120, Heidelberg, Germany

    Thomas Bruckner MSc

Authors
  1. Lars Fischer MD
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  2. Phillip Knebel MD
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  3. Steffen Schröder MS
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  4. Thomas Bruckner MSc
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  5. Markus K. Diener MD
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  6. Roland Hennes MD
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  7. Klaus Buhl MD
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  8. Bruno Schmied MD
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  9. Christoph M. Seiler MD
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Corresponding author

Correspondence to Lars Fischer MD.

Additional information

Lars Fischer and Phillip Knebel contributed equally to this study.

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Fischer, L., Knebel, P., Schröder, S. et al. Reasons for Explantation of Totally Implantable Access Ports: A Multivariate Analysis of 385 Consecutive Patients. Ann Surg Oncol 15, 1124–1129 (2008). https://doi.org/10.1245/s10434-007-9783-z

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  • DOI: https://doi.org/10.1245/s10434-007-9783-z

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