[Complications after insertion of a totally implantable venous access port in patients treated with chemotherapy for head and neck squamous cell carcinoma]. / Complications d'un dispositif intraveineux implantable pour chimiothérapie dans les cancers des voies aérodigestives supérieures.

OBJECTIVES: To review the occurrence of early and delayed complications after insertion of a totally implantable venous access port (Tivap) in patients treated with chemotherapy for head and neck squamous cell carcinoma. MATERIAL AND METHODS: Monocentric prospective study (2005-2008) undertaken in a tertiary referral center. In all cases, the inserted Tivap was a Celsite ST301 (Braun) model. The insertion procedure was performed in operating room conditions under local anesthesia using a surgical cut-down method. No antibiotic prophylaxis or long-term anticoagulant medications were administered. Two groups were made between experienced and in-training surgeons. All complications occurring from the date of Tivap insertion to the date of its removal or until the closure of the study were included. RESULTS: The study comprised of 122 patients including 103 males and 19 females; the patients' mean age was 58.5 years (range, 36-80). Twelve (9.8%) had a tracheotomy or tracheostomy and 41 (33.6%) underwent cervical radiotherapy before Tivap insertion. In 63 cases (51.6%), the procedure was performed by a senior surgeon. The inserted vessel was the cephalic vein (84.4%), the external jugular vein (11.5%) or the internal jugular vein (2.5%). Overall, the total number of days of Tivap implantation was 51,403. Altogether, 11 complications (9%) were listed: two (1.6%) early complications and nine (7.4%) delayed complications. We did not uncover a significant statistical relation between complication onset and experience of the operating surgeon, sex, implanted side, tracheotomy, previous radiotherapy, or number of days of Tivap port. CONCLUSION: Our study suggests that: (1) complications are rare provided careful implantation and manipulation methods are followed by health personnel; (2) surgical cephalic cut-down is a very reliable method; and 3) antibiotic prophylaxis or long-term anticoagulant medications are not mandatory.