Nijagal Mutt, J B (2014) Utility of chemoport in paediatric oncological patients, a surgical perspective. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION : A totally implantable access device or ‘chemoport’ is a small medical appliance that is installed beneath the skin. A catheter connects the port to a central vein with a large inflow of blood. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn repeatedly, usually with far less discomfort for the patient than a more typical "needle stick". Ports are used mostly to treat oncology and hematology patients, but recently ports have been adapted also for hemodialysis patients. But, in our institute we use it for various paediatric oncological diseases. In this retrospective study, we try to study the number of patients who underwent chemoport insertions, the duration for which the chemoport was in situ and the number of patients who successfully completed chemotherapy. We have also tried to study the chemoport related complications and reasons for removal of the chemoports. AIM/OBJECTIVES : To assess the utilization, indications for insertion, removal and risk factors responsible for the premature removal of the chemoports. MATERIALS AND METHODS : All children who underwent chemoport insertion between January 2007 and December 2013 were included in this study. This was a retrospective study. The details of eligible patient were obtained from the clinical work station and centenary block operation register. Data were analysed using 2*2 tables for odd’s ratio and chi square test was employed to know the significance of the risk factors with the use of SPSS software version 1.6. RESULTS : 239 children were studied for the period between January 2007- December 2013. 69 of the children had completed treatment, 97 were still undergoing chemotherapy, 32 had complications like infection, thrombosis, extravasation, broken catheter and hematoma, deaths were seen in 17 children with chemoport in situ and 24 were lost to follow up. The median duration for which chemoport remained in situ including those with complications was 273 days. Amongst the risk factors leading to premature removal of the chemoport studied namely; pre insertion chemotherapy, duration of surgery, seniority of the surgeon, serum albumin, prothrombin time, INR, Platelet count, total count and absolute neutrophil count at insertion. Absolute neutrophil count was the sole factor that reached statistical significance with a P value of 0.03. CONCLUSION : Chemoport is a good tool for vascular access in paediatric cancer patients requiring long term chemotherapy Chemoports are not without complications. The most common complications are infectious complications amounting to 10.87% of our study population. Absolute neutrophil count <500 cells/microlitre is a strong predictor of complications with chemoport at any stage of chemotherapy.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Chemoport, thrombosis, infection, absolute neutrophil count. |
| Subjects: | MEDICAL > Paediatric Surgery |
| Depositing User: | Kambaraman B |
| Date Deposited: | 01 Aug 2017 03:26 |
| Last Modified: | 01 Aug 2017 08:28 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2410 |
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