J Vis Exp. 2025 Nov 4;(225). doi: 10.3791/69023.
ABSTRACT
Totally implantable venous access ports (TIVAPs) are essential for chemotherapy in malignant tumor patients, but catheter blockage and infection remain concerns. The standard 4-week maintenance interval increases financial and logistical burdens, and its necessity in hypercoagulable patients is unclear. This retrospective study analyzed 303 patients with malignant tumors and TIVAPs treated between June 2021 and June 2023. Based on maintenance frequency, patients were categorized into Group A (4-week, n = 97), Group B (8-week, n = 101), and Group C (12-week, n = 105). Clinical outcomes and complication rates were compared, and patients were further divided into complication (n = 51) and non-complication (n = 252) groups to identify risk factors. Compared with the standard 4-week interval, extending maintenance to 8 or 12 weeks significantly reduced 48-week costs by 50.66% and 65.91%, respectively, without increasing thrombosis (Wells score: P = 0.723) or complication rates (P = 0.872). Follow-up compliance improved as maintenance frequency decreased (24-week compliance: Group C 28.9 ± 2.5 vs. Group A 22.3 ± 3.1, P < 0.001). No significant differences were observed among groups in thrombosis risk, catheter patency, quality of life, or overall complication rates (P > 0.05). Group A incurred the highest costs, Group C the lowest, and patient satisfaction peaked in Group B. Multivariate analysis identified older age (OR = 1.048, 95% CI 1.018-1.079), higher BMI (OR = 5.072, 95% CI 1.238-20.775), and chronic diseases (OR = 3.391, 95% CI 1.761-6.531) as independent risk factors for port-related complications. In conclusion, extending TIVAP maintenance intervals to 8-12 weeks after chemotherapy is safe, reduces costs, and enhances compliance. However, patients who are older, overweight, or have chronic conditions require closer monitoring during non-chemotherapy periods.
PMID:41284689 | DOI:10.3791/69023