Alexander Werba, Roland Hennes, Fabian Schuh, Magdalena Holze, Barbara Maichle, Ali Ramouz, Mark Bauer, Kai Braunsteffer, Phillip Knebel, Rosa Klotz, Frank Pianka
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引用次数: 0
Abstract
Purpose: Long-term totally implantable venous access ports (TIVAP) are essential for administering chemotherapy and parenteral nutrition in cancer patients. This study aimed to evaluate patient satisfaction and postoperative complications, compared to existing literature, emphasizing patient-reported outcomes (PRO) as a critical factor in treatment decisions.
Methods: A prospective, monocentric observational study included 149 patients requiring TIVAP between April 13 and August 17, 2022. Patient satisfaction was assessed using a questionnaire covering four domains: overall satisfaction, willingness to choose the port again, cosmetic result, and pain experience. A meta-analysis of seven studies (1,035 patients) was performed to establish baseline data. The study assumed a non-inferiority margin of 12 points on a 0-100 scale (lower scores indicating better outcomes). Follow-ups were carried out at four weeks and six months.
Results: Of the 149 patients (mean age 58.8 years, 96% with oncological diseases), 117 (78.5%) TIVAPs were implanted via the cut-down technique, primarily using the cephalic vein (84.6%). Out of 1,240 documented catheter accesses, 91.4% were complication-free. Satisfaction scores demonstrated non-inferiority across all domains compared to literature: overall satisfaction (18.5 vs. 35.6; p < 0.001), willingness to choose the port again (15.8 vs. 29.4; p < 0.001), cosmetic result (38.0 vs. 39.9; p = 0.003), and pain experience (17.1 vs. 31.5; p < 0.001).
Conclusion: The study demonstrated adequate patient satisfaction and non-inferiority of the investigated TIVAP system compared to other systems, though no superiority was found in cosmetic outcomes.
目的:长期全植入式静脉通道(TIVAP)是肿瘤患者化疗和肠外营养的重要手段。与现有文献相比,本研究旨在评估患者满意度和术后并发症,强调患者报告的预后(PRO)是治疗决策的关键因素。方法:一项前瞻性、单中心观察性研究,包括在2022年4月13日至8月17日期间需要TIVAP的149例患者。患者满意度评估采用问卷调查涵盖四个领域:总体满意度,再次选择端口的意愿,美容效果和疼痛体验。对7项研究(1035例患者)进行荟萃分析以建立基线数据。该研究假设在0-100的范围内,非劣效性差为12分(分数越低表明结果越好)。随访时间分别为4周和6个月。结果:149例患者(平均年龄58.8岁,96%有肿瘤疾病)中,117例(78.5%)采用切口技术植入tivap,主要采用头静脉植入(84.6%)。在1240例记录在案的导管置入中,91.4%无并发症。与文献相比,满意度得分显示所有领域的非劣效性:总体满意度(18.5 vs. 35.6;结论:本研究表明,与其他系统相比,所调查的TIVAP系统具有足够的患者满意度和非劣效性,尽管在美容结果方面没有发现优势。
期刊介绍:
Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.