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Jia HY, Yan LQ, Liu XB, Cao J. Correlation between psychological, family social support, and home nursing quality for an implanted venous access port. World J Psychiatry 2025; 15:99252. [PMID: 39974473 PMCID: PMC11758035 DOI: 10.5498/wjp.v15.i2.99252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 12/01/2024] [Accepted: 12/23/2024] [Indexed: 01/14/2025] Open
Abstract
BACKGROUND Cancer patients with an implanted venous access port (IVAP) often manage their care at home during chemotherapy intervals, including maintaining the device, monitoring complications, and following medication instructions. Home care ensures continued support after discharge. However, due to factors such as age, gender, culture, psychological status, and family support, the quality of home care varies significantly. Understanding these factors can help provide targeted guidance to improve the care of cancer patients. AIM To explore IVAP chemotherapy on home care quality and its association with mental health and family support for cancer patients. METHODS This investigative study was based on a medical records system. It investigated the relationship between psychological status, family support, and home care quality in 180 patients with cancer undergoing IVAP chemotherapy. Psychological status was assessed using the State Anxiety Inventory (S-AI); family support was assessed using the Perceived Social Support Scale (PSSS), and home care quality was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Pearson's correlation and Structural Equation Modeling were used to analyze the interplay between these factors. RESULTS The average S-AI score was 47.52 ± 14.47, PSSS was 52.48 ± 12.64, and EORTC QLQ-C30 was 70.09 ± 17.32. A substantial inverse relationship was observed between the EORTC QLQ-C30 and S-AI scores (r = -0.712). A significant positive correlation was found between the EORTC QLQ-C30 and the PSSS, with a correlation coefficient of (r = 0.744). The multiple linear regression analysis indicated that family social support, psychological status, and average monthly family income were the main factors influencing the variation in the quality of home care, explaining 71.9% of the variation. The Structural Equation Modeling results indicated that psychological status acted as a partial mediator in the association between family social support and home care quality of life, explaining 32.78% of the mediation effect. CONCLUSION Psychological status and family social support positively impacted cancer patients' home care quality, with psychology partially mediating this effect.
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Affiliation(s)
- Heng-Ya Jia
- Department of Emergency, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Li-Qun Yan
- Department of Emergency, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Xiao-Bei Liu
- Department of Neuropsychology, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Jie Cao
- Department of Urology, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
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Wang M, Tang L, Xu R, Qin S, Zhang S. Clinical application of ultrasound-guided totally implantable venous access ports implantation via the posterior approach of the internal jugular vein. J Chin Med Assoc 2024; 87:126-130. [PMID: 38016115 DOI: 10.1097/jcma.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND To determine the feasibility and safety of ultrasound-guided totally implantable venous access port (TIVAP) implantation via the posterior approach of the internal jugular vein (IJV). METHODS From September 2021 to August 2022, 88 oncology patients underwent ultrasound-guided implantation of TIVAPs via the posterior approach of the IJV for the administration of chemotherapy. The catheter tip was adjusted to be positioned at the cavoatrial junction under fluoroscopic guidance. Clinical data including surgical success, success rate for the first attempt, intraoperative, and postoperative complications were all collected and analyzed. RESULTS All patients underwent successful surgery (100%), whereby 58 were via the right IJV and 30 via the left IJV, and the success rate for the first attempt was 96.59% (85/88). The operation time was 20 to 43 minutes, with an average of 26.59 ± 6.18 minutes with no intraoperative complications. The follow-up duration ranged from 1 to 12 months (mean = 5.28 ± 3.07) and the follow-up rate was 100%. The rate of postoperative complications was 4.55% (4/88), including port-site infection in two cases, fibrin sheath formation in one case, and port flip in one case. No other complications were observed during follow-up. CONCLUSION Ultrasound-guided TIVAP implantation via the posterior approach of the IJV is feasible, safe, and effective, with a low rate of intraoperative and postoperative complications. Not only was the curvature of the catheter device smooth, but patients were satisfied with the comfort and cosmetic appearance. Additionally, we could reduce the possible complications of pinching and kinking of the catheter by using this approach. Therefore, further large-sample, prospective, and randomized controlled trials are warranted.
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Affiliation(s)
- Minghai Wang
- Department of General Surgery, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Linna Tang
- Department of Hospital Infection Control, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Rongwei Xu
- Department of General Surgery, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Shiyong Qin
- Department of General Surgery, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Shuguang Zhang
- Department of General Surgery, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
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Xu L, Qin W, Zheng W, Sun X. Ultrasound-guided totally implantable venous access ports via the right innominate vein: a new approach for patients with breast cancer. World J Surg Oncol 2019; 17:196. [PMID: 31767003 PMCID: PMC6878705 DOI: 10.1186/s12957-019-1727-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/15/2019] [Indexed: 12/26/2022] Open
Abstract
Background To evaluate the feasibility and safety of ultrasound-guided totally implantable venous access port (TIVAP) implantation via the right innominate vein in patients with breast cancer. Methods Sixty-seven breast cancer patients underwent ultrasound-guided implantation of TIVAPs via the right innominate vein for administration of chemotherapy. Clinical data including technical success, success rate for the first attempt, periprocedural, and postoperative complications were recorded and retrospectively studied. Results All patients underwent successful surgery. The success rate of the first attempt was 95.52% (64/67). The operation time was 28 to 45 min, with an average of 36 ± 6 min. Periprocedural complications included artery punctures in 1 (1.50%, 1/67) patient. Prior to this study, the mean TIVAP time was 257 ± 3 days (range 41 to 705 days). The rate of postoperative complications was 4.48% (3/67), including catheter-related infections in 1 case and fibrin sheath formation in 2 cases. Up to the present study, three people had unplanned port withdrawal due to complications, and the TIVAPs for 25 patients were still in normal use. Conclusions The success rate of ultrasound-guided TIVAPs via the right innominate vein is high with low complications, thus safe and feasible. This technique can provide a new option for chemotherapy of breast cancer patients.
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Affiliation(s)
- Liang Xu
- Department of General Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, 215500, Jiangsu, China
| | - Wenming Qin
- Department of Pain, Bazhong Central Hospital, Bazhong, 636000, Sichuan, China
| | - Weiwei Zheng
- Department of Orthopaedics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215004, Jiangsu, China.
| | - Xingwei Sun
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, China.
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Tsuruta S, Goto Y, Miyake H, Nagai H, Yoshioka Y, Yuasa N, Takamizawa J. Late complications associated with totally implantable venous access port implantation via the internal jugular vein. Support Care Cancer 2019; 28:2761-2768. [PMID: 31724073 DOI: 10.1007/s00520-019-05122-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/06/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE Several studies have analyzed late complications associated with totally implantable venous access ports (TIVAP) implantation via the internal jugular vein (IJV); however, the reported results are inconclusive. The aim of the study is to elucidate the characteristics and risk factors of late complications associated with TIVAP implantation via the IJV. METHODS The study included 482 patients who underwent TIVAP implantation for long-term chemotherapy and/or nutritional support between April 2012 and December 2017. Most patients (95.2%) had malignant diseases. Events requiring TIVAP removal were defined as TIVAP-related complications. RESULTS The median TIVAP and global follow-ups were 319 days (IQR 152-661) and 218,971 catheter days, respectively. The 3-year cumulative TIVAP availability rate was 70%. There were 44 complications (incidence of 9.1%; 0.201 complications/1000 catheter days). Infectious, catheter-related, and port-related complications occurred in 21, 14, and 9 patients, respectively with infectious complications occurring earlier and more frequently than catheter- and port-related complications. Multivariate analysis revealed that age < 65 years and presence of non-gastrointestinal diseases were significant unfavorable factors for TIVAP-related complications. Patients with 1 and 2 of these factors had an elevated risk (2.2 and 5.4 times, respectively) compared with those without. CONCLUSIONS Among the late complications associated with TIVAP implantation via the IJV, infectious complications occur earlier and more frequently than catheter- and port-related complications. Patients with an age < 65 years and having non-gastrointestinal diseases have a significantly high risk of TIVAP-related complications.
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Affiliation(s)
- Shigeaki Tsuruta
- Department of Surgery, Japanese Red cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Yasutomo Goto
- Department of Surgery, Japanese Red cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Hideo Miyake
- Department of Surgery, Japanese Red cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Hidemasa Nagai
- Department of Surgery, Japanese Red cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Yuichiro Yoshioka
- Department of Surgery, Japanese Red cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Norihiro Yuasa
- Department of Surgery, Japanese Red cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan.
| | - Junichi Takamizawa
- Department of Laboratory Medicine, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
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Zhang X, Geng C. Unsuccessful removal of a totally implantable venous access port caused by thrombosis in the left brachiocephalic vein: A case report. Medicine (Baltimore) 2019; 98:e14985. [PMID: 30921208 PMCID: PMC6455955 DOI: 10.1097/md.0000000000014985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Thrombosis is a common complication associated with implantable venous access ports (IVAPs) and often results in loss of catheter function but is rarely associated with difficulty in IVAP removal. PATIENT CONCERNS A 53-year-old woman presented to the hospital due to difficulty in IVAP removal. The patient had been diagnosed with breast cancer and received modified radical mastectomy. After that, she underwent IVAP implantation. Four and half years later, the IVAP catheter had become stuck while the catheter remained unobstructed. The patient had no special chief complaints. DIAGNOSIS Postoperative breast cancer; difficulty in removal of IVAP (caused by thrombus in the left brachiocephalic vein). INTERVENTIONS We injected urokinase 5 ml 1000U/L into the catheter once a day for three days but failed to remove the IVAP. Vasography showed a thrombus in the left brachiocephalic vein. Removal of the thrombus would have been very dangerous, so we decided to leave both thrombus and catheter in the body and used heparin and warfarin as anticoagulants. OUTCOMES The general situation of the patient, followed-up for 20 months, was good and there was no psychological impact or other special chief complaints. LESSONS It is best to remove the IVAP in a timely manner once all treatments are finished.
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Sun X, Zhang Y, Yang C, Zhou Y, Bai X, Zheng W, Jin Y. Ultrasound-guided totally implantable venous access device through the right innominate vein in older patients is safe and reliable. Geriatr Gerontol Int 2019; 19:218-221. [PMID: 30724007 DOI: 10.1111/ggi.13611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/15/2018] [Accepted: 11/30/2018] [Indexed: 11/26/2022]
Abstract
AIM Ultrasound guidance has become the routine method for catheterization, dramatically reducing failure and complication rates for totally implantable venous access devices (TIVAD) placement. The aim of the present study was to report the safety and efficacy of ultrasound-guided right innominate vein TIVAD placement in older patients. METHODS Between September 2015 and September 2017, 55 older patients underwent right innominate vein TIVAD placement under ultrasound guidance. Intraoperative fluoroscopy was always carried out. The technical success rate and complications were recorded and retrospectively analyzed. RESULTS The technical success rate was 100%. The success rate of the first puncture was 96.36% (53/55). The mean operation time was 28 ± 7 min (range 23-39 min), and the mean length of catheter introduction was 19.24 ± 2.65 cm (range 17-21 cm). The overall incidence of complications was 7.27% (4/55), including one arterial puncture with self-limiting hematoma, two cases of catheter-related infection and one case of fibrin sheath. No catheter malposition or catheter fracture was observed. At the time of this study, three TIVAD were pulled out unexpectedly, and 32 TIVAD are still in functional use. CONCLUSIONS Ultrasound-guided puncture of the right innominate vein is safe and reliable to implant TIVAD, which can provide new options for older patients. Geriatr Gerontol Int 2019; 19: 218-221.
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Affiliation(s)
- Xingwei Sun
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Zhang
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chuanlai Yang
- Department of Science and Education, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yubin Zhou
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuming Bai
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Weiwei Zheng
- Department of Orthopedics, Suzhou Hospital affiliated to Nanjing Medical University, Suzhou, China
| | - Yong Jin
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Efficacy and safety of ultrasound-guided totally implantable venous access ports via the right innominate vein in adult patients with cancer: Single-centre experience and protocol. Eur J Surg Oncol 2018; 45:275-278. [PMID: 30087070 DOI: 10.1016/j.ejso.2018.07.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/11/2018] [Accepted: 07/18/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Totally implantable venous access ports (TIVAPs) are widely used and are an essential tool in the efficient delivery of chemotherapy. This study aimed to evaluate the feasibility and safety of implantation of ultrasound (US)-guided TIVAPs via the right innominate vein (INV) for adult patients with cancer. METHODS This study retrospectively reviewed the medical records of 283 adult patients with cancer who underwent US-guided INV puncture for TIVAPs between September 2015 and September 2017. It also analysed the technical success rate, operation time, and short-term and long-term surgical complications. RESULTS Technical success was achieved in all patients (100%). The mean operation time was 28.31 ± 7.31 min (range: 23-39 min), and the puncture success rate for the first attempt was 99.30% (281/283). Minor complications included artery puncture during the operation in one patient, but no pneumothorax was encountered. The mean TIVAP time was 304.16 ± 42.54 days (range: 38-502 days). The rate of postoperative complications was 2.83% (8/283), including poor healing of the incision in one patient, catheter-related infections in three patients, port thrombosis in one patient, and fibrin sheath formation in three patients; no catheter malposition, pinch-off syndrome, catheter fracture, or other serious complications were observed. CONCLUSIONS TIVAPs are widely employed for chemotherapy. The present study found that the novel approach of using US-guided INV puncture to implant TIVAPs in adult patients with cancer is both short-termly feasible and safe for long-term central venous access.
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Wu K, Lai H, Liu Y, Zhang B. Percutaneous transvenous retrieval of fractured catheter in cancer patients receiving chemotherapy. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2018; 26:1029-1037. [PMID: 30320599 DOI: 10.3233/xst-180430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore the clinical efficacy and safety of percutaneous transvenous retrieval of intravascular fractured catheter and to evaluate the possible reasons and final results in cancer patients. METHODS A dataset of 19 patients was used. Percutaneous transvenous retrieval of intravascular fractured catheter was performed in each patients. Clinical data was retrospectively analyzed with respect to the efficacy, safety and outcome, and chest radiography was performed to verify that no catheter fragments were left. RESULTS Two cases had peripherally inserted central catheter and 17 had subcutaneous implanted port catheter. The catheter fragments were located in the brachiocephalic vein-superior vena cava (n = 1), superior vena cava (n = 1), superior and inferior vena cava (n = 1), superior vena cava-right atrium (n = 2), brachiocephalic vein-superior vena cava-right atrium (n = 1), superior vena cava-right atrium-right ventricle (n = 6), brachiocephalic vein-superior vena cava-right atrium and right ventricle (n = 1) and pulmonary artery (n = 6), respectively. All of these catheter fragments were retrieved successfully. No complications such as bleeding and thrombosis were found. CONCLUSION Percutaneous transvenous retrieval is a safe, minimally invasive and relatively simple procedure for the patients with fractured catheter and should be recommended as the first choice.
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Affiliation(s)
- Ketong Wu
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Haiyang Lai
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang Liu
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bo Zhang
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Ko SY, Park SC, Hwang JK, Kim SD. Spontaneous fracture and migration of catheter of a totally implantable venous access port via internal jugular vein--a case report. J Cardiothorac Surg 2016; 11:50. [PMID: 27067705 PMCID: PMC4827203 DOI: 10.1186/s13019-016-0450-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 04/04/2016] [Indexed: 11/21/2022] Open
Abstract
Background The totally implantable venous access ports (TIVAPs) are indicated for patients undergoing chemotherapy, total parenteral nutrition and long-term antibiotic treatment. But, among their complications, the fracture and migration of the catheter of a TIVAP via internal jugular vein represents a very rare but potentially severe condition. Case presentation A 50-year-old woman indentified with a spontaneous fracture and migration of catheter of a TIVAP via right internal jugular vein after adjuvant chemotherapy for ovary cancer. She had been not evaluated and not managed with the heparin lock flush solution during three months after adjuvant chemotherapy. And then, she complained right neck bulging during saline infusion via a TIVAP and a chest radiography showed the fractured and migrated catheter of a TIVAP in right atrium. So, we emergently removed the catheter fragment by a goose neck snare via right femoral vein. After then, there was no problem. Conclusions If the fractured catheter of a TIVAP is detected, it is desirable to remove a fragment by an endovascular approach if it is possible.
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Affiliation(s)
- Seung Yeon Ko
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Cheol Park
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Kye Hwang
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Dong Kim
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyong-Gu, Incheon, 403-720, Korea.
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