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2003, Number 3

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Rev Med Hosp Gen Mex 2003; 66 (3)

Placement of central catheter during operation in patients with breast cancer who require collateral chemotherapy

Miranda HH, Mociños MR, Peña VJ, Sánchez FE, Lázaro LM

Language: Spanish
References: 14
Page: 126-130
PDF size: 144.61 Kb.


ABSTRACT

Background. Female patients with breast cancer in regionally advanced stages require the application of collateral chemotherapy and radiotherapy, in this purpose long-lasting central intravenous catheters have been used. The techniques are generally applied as a blind procedure, frequently producing complications such as hemothorax or hydrothorax, burst arteries or veins, etc. For this reason, the cancer tumor unit of the Hospital General of Mexico has developed a new technique for placing catheters during operations in patients with breast cancer who require chemotherapy (clinical stages IIA and IIB). Objective. To present a new technique for placing the A-port catheter during operations. Material and methods. Since March 1999 60 type A-port 9 Fr caliber, long- lasting intravenous catheters have been placed during operations through the external mammary vein or lower thoracic vein in patients with clinical stage IIA or IIB, treated with conservative surgery or modified radical mastectomy with or without preserving the lower pectoral muscle. Results. There were no technical difficulties or complications; the average time required for the placement was under 10 minutes and it was confirmed by x-ray that the tip of the catheter was located in the upper vena cava or right auricle. The average follow-up with the catheter inserted was from eight to eleven months and only one case of cellulitis occurred in the site of the subcutaneous reserve. The application of drugs did not present complications for the chemo-therapist and the catheter was withdrawn routinely at the conclusion of the collateral chemotherapy. Conclusions. We believe this technique constitutes an excellent option for placing these catheters, thus avoiding the complications reported with other techniques, such as perforation of the visceral pleura, perforation or bursting of the subclavian artery and vein, hydrothorax, cephalization of the catheter, etc.


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