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Duggan C, Hernon O, Dunne R, McInerney V, Walsh SR, Lowery A, McCarthy M, Carr PJ. Vascular access device type for systemic anti-cancer therapies in cancer patients: A scoping review. Crit Rev Oncol Hematol 2024; 196:104277. [PMID: 38492760 DOI: 10.1016/j.critrevonc.2024.104277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Patients with cancer can expect to receive numerous invasive vascular access procedures for intravenous therapy and clinical diagnostics. Due to the increased incidence and prevalence of cancer globally there will be significantly more people who require first-line intravenous chemotherapy over the next ten years. METHODS Our objective was to determine the types of evidence that exist for the vascular access device (VAD) type for the delivery of systemic anti-cancer therapy (SACT) in cancer patients. We used JBI scoping review methodology to identify the types of VADs used for SACT and with a specific search strategy included articles from 2012-2022 published in the English language. We identify (i) type of VADs used for SACT delivery (ii) the type of insertion and post-insertion complications (iii) the geographical location and clinical environment (iv) and whether VAD choice impacts on quality of life (QOL). Findings were presented using the PAGER framework. MAIN FINDINGS Our search strategy identified 10,390 titles, of these, 5318 duplicates were removed. The remaining 5072 sources were screened for eligibility, 240 articles met the inclusion criteria. The most common design include retrospective study designs (n = 91) followed by prospective study designs (n = 31). We found 28 interventional studies with 21 registered in a clinical trial registry and identified no core outcome sets papers specific to VAD for SACT. The most prevalent publications were those that featured two or more VAD types (n = 70), followed by tunnelled intravenous VADs (n = 67). Of 38 unique complications identified, the most frequent catheter related complication was catheter related thrombosis (n = 178, 74%), followed by infection (n = 170, 71%). The county where the most publications originated from was China (n = 62) with one randomized controlled multicenter study from a comprehensive cancer centre. Of the thirty three studies that included QOL we found 4 which reported on body image. No QOL measurement tools specific to the process of SACT administration via VAD are available INTERPRETATION: Our findings suggest a systematic review and meta-analysis of VAD use for intravenous SACT can be considered. However, the development of a core outcome set for SACT should be prioritised. Funding for high quality programs of research for VAD in cancer are needed. Comprehensive cancer centres should lead this research agenda.
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Affiliation(s)
- C Duggan
- Department of Oncology, Portiuncula Hospital, Ballinasloe, Galway H53 T971, Ireland; School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia.
| | - O Hernon
- School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia
| | - R Dunne
- Library, University of Galway, Ireland
| | - V McInerney
- HRB Clinical Research Facility, University of Galway, Ireland
| | - S R Walsh
- Department of Vascular Surgery, Galway University Hospital, Ireland
| | - A Lowery
- School of Medicine, University of Galway, Ireland
| | - M McCarthy
- Department of Medical Oncology, Galway University Hospital, Ireland
| | - P J Carr
- School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia
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Pizzuti G, Cassani C, Bottazzi A, Ruggieri A, Della Valle A, Dionigi F, Anghelone CAP, Sgarella A, Ferrari A. Impact of totally implanted venous access port placement on body image in women with breast cancer. J Vasc Access 2024; 25:673-676. [PMID: 36401349 PMCID: PMC10938480 DOI: 10.1177/11297298221136330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
Totally implanted venous access ports (TIVAPs) have been established as effective and safe devices for oncologic patients. In breast cancer setting, the implant of the reservoir at mid-arm allows the absence of additional scars on the chest and the easier access to the port with significant cosmetic and psychological advantages. In the last decades, breast surgery has made great progresses to ameliorate the cosmetic results even in mastectomy techniques. In fact, many studies have demonstrated that negative body image perception affects physical and psychological wellbeing of survivors. Despite this evidence, limited importance is still reserved to TIVAPs placement site, which is traditionally the chest. It is not unusual to see patients after a nipple-sparing mastectomy with excellent cosmetic result who show a disfiguring scar on their upper chest due to TIVAP placement. We report the case of a young woman with BRCA2-related breast cancer who underwent bilateral nipple sparing mastectomy with immediate reconstruction and adjuvant chemotherapy. Her TIVAP was located at the mid-arm, which is still an uncommon site compared to the upper chest. An optimal cosmetic result was obtained both in breast reconstruction and in the arm site of port, with high-rate patient satisfaction. This case presentation aims to raise awareness towards women's body image preservation, particularly in the choice of TIVAP placement: in most cases neckline and upper chest should be avoided for a better patient related outcome.
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Affiliation(s)
- Giada Pizzuti
- Department of Surgery, General Surgery III—Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Chiara Cassani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Bottazzi
- Unit of Anesthesia and Resuscitation 1-4, Vascular Access Service; Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annamaria Ruggieri
- Department of Surgery, General Surgery III—Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Angelica Della Valle
- Department of Surgery, General Surgery III—Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Dionigi
- Department of Surgery, General Surgery III—Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- School in Experimental Medicine, University of Pavia, Pavia, Italy
| | | | - Adele Sgarella
- Department of Surgery, General Surgery III—Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Alberta Ferrari
- Department of Surgery, General Surgery III—Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Wang Y, Wang X, Qiu X. Indwelling experience and coping strategies of upper arm infusion ports in patients with cancer: a qualitative study. BMJ Open 2023; 13:e069772. [PMID: 36948557 PMCID: PMC10040049 DOI: 10.1136/bmjopen-2022-069772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVES The upper arm infusion ports have been proven to be advanced and safe, but the experience from the perspective of patients is lacking. This study explored the indwelling experience and coping strategies of upper arm infusion ports in patients with cancer. DESIGN Qualitative exploratory study. SETTING This study was conducted between May 2021 and August 2021 at a level III-A general hospital in Shanghai, China. PARTICIPANTS The participants, who are patients with cancer implanted with the upper arm infusion ports, included 10 women and 6 men, and the average age was 54.4±8.3 years old. METHODS Data were selected from semistructured in-depth interviews and analysed by thematic analysis. RESULTS There were 10 descriptive topics and 4 analytical topics in 2 parts. The indwelling experience includes positive experience (treatment benefit, life convenience) and negative experience (physical discomfort, social anxiety, psychological distress). Coping strategies include emotional-focused strategies (self-acceptance, avoidance and self-protection) and problem-focused strategies (information seeking, functional exercise and remove as soon as possible). CONCLUSION The infusion port in the upper arm is beneficial to the safety and quality of life of patients with cancer. At the same time, there are challenges in physical, psychological and social adaptation. Patients respond with some measures, but obstacles may arise during implementation.
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Affiliation(s)
- Yawen Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Oncology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoxia Qiu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Oncology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
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Ivziku D, Gualandi R, Pesce F, De Benedictis A, Tartaglini D. Adult oncology patients' experiences of living with a central venous catheter: a systematic review and meta-synthesis. Support Care Cancer 2022; 30:3773-3791. [PMID: 35031831 DOI: 10.1007/s00520-022-06819-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The incidence of cancer is increasing globally, and a greater number of patients will receive treatments though central vascular access devices (CVADs). Only a few qualitative studies describe the experience of adult oncology patients living with CVADs, and no systematic review of literature has been published on this topic. We therefore aimed to systematically synthesize the evidence of the qualitative studies on the experience of adult oncology patients with CVADs to report the implications of living with this device, and to inform healthcare professionals (HCPs) about problematic aspects of care for this population. METHODS A comprehensive literature review was conducted on PUBMED, MEDLINE, SCOPUS, COCHRANE, and WEB OF SCIENCE, and was updated on May 25, 2021. Nine studies fulfilled the inclusion criteria. The evidence was synthesized using the meta-aggregation approach proposed by the Joanna Briggs Institute. RESULTS Four themes emerged: During catheter implantation oncology patients typically experience reluctance, apprehension and acceptance; The nature of the information, knowledge transmission and HCPs' competence all influence the patient's confidence; How the presence of a catheter impacts the patient's daily life, their self-perception and their social behavior; The catheter is a symbol of disease, a friend that helps prevent problems, and its removal is perceived as physical and psychological liberation. CONCLUSION This systematic review evidenced some problematic aspects related to patient information, education and device management, and gaps in nursing skills on handling the device. The results of this review should be used as a framework for improvement interventions.
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Affiliation(s)
- Dhurata Ivziku
- Department of Nursing Innovation and Development, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - Raffaella Gualandi
- Department of Health Professions, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | | | - Anna De Benedictis
- Department of Clinical affairs, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - Daniela Tartaglini
- Department of Health Professions, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy
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Kim H, Kwon S, Son SM, Jeong E, Kim JY. Tailored approach to the choice of long-term vascular access in breast cancer patients. PLoS One 2021; 16:e0255004. [PMID: 34293064 PMCID: PMC8297812 DOI: 10.1371/journal.pone.0255004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/07/2021] [Indexed: 01/14/2023] Open
Abstract
This study compared the possible options for vascular access in breast cancer patients by analyzing the complications of each method. We retrospectively evaluated the vascular access procedures for intravenous chemotherapy in breast cancer patients from 2016 to 2018. A total of 300 consecutive patients were included, 100 each who received peripherally inserted central catheters (PICCs), arm ports, and chest ports. When selecting a catheter, a PICC was considered when four cycles of chemotherapy were expected. Otherwise, patient preference was considered. All but one patient with an arm port were women, with mean age of 51.7 ± 9.1 years. The total mean complication-free catheter indwelling time was 1357.6 days for chest ports, 997.8 days for arm ports, and 366.8 days for PICCs (p = 0.004). There were 11 catheter-related complications (3.7%), one in a chest port patient, five in arm port patients, and eight in PICC patients. There was no patient with catheter related blood stream infection or deep vein thrombosis. All three types of catheters could be used in breast cancer patients without causing serious complications. The selection of catheter considering the clinical situation was effective for providing a safe and secure chemotherapy delivery route.
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Affiliation(s)
- Hyangkyoung Kim
- Division of Vascular Surgery, Department of Surgery, College of Medicine, University of Ulsan and Asan Medical Center, Seoul, Korea
| | - Sukyung Kwon
- Division of Vascular Surgery, Department of Surgery, College of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Soo Mi Son
- Division of Vascular and Transplantation Surgery, Department of Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Eunseon Jeong
- Division of Vascular and Transplantation Surgery, Department of Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jang-Yong Kim
- Division of Vascular and Transplantation Surgery, Department of Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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Tang TT, Liu L, Li CX, Li YT, Zhou T, Li HP, Wang J. Which is Better for Patients with Breast Cancer: Totally Implanted Vascular Access Devices (TIVAD) or Peripherally Inserted Central Catheter (PICC)? World J Surg 2019; 43:2245-2249. [PMID: 31098669 DOI: 10.1007/s00268-019-05022-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Our aim was to compare the applications of totally implanted vascular access devices (TIVAD) and peripherally inserted central catheter (PICC) in breast cancer patients. METHODS We analyzed 4080 cases of TIVAD and 1433 cases of PICC at the Breast Center of the Fourth Hospital of Hebei Medical University. The success rate, operation time, and procedures of catheterization, as well as the catheterization-related complications, catheter indwelling-related complications, and the utilization conditions were compared between these two methods. RESULTS Our results showed that the success rate of catheterization was relatively higher in PICC group (99.5%) than the TIVAD group (99.0%)(χ2 = 3.521, P = 0.038), and the operation time and the rate of catheterization-related complications were lower in PICC (18.65 ± 4.7603 min, 0.91%) compared to TIVAD (29.55 ± 4.0843 min, 1.59%)(t = 38.000, P < 0.01, χ2 = 3.578, P = 0.035). However, the rate of catheter indwelling-related complications was lower in TIVAD group (2.47%) than the PICC group (3.62%)(χ2 = 5.227, P = 0.016), and the catheter care was also better in TIVAD. CONCLUSIONS Based on these analyses, we recommended TIVAD for the patients who need long-term and high-dose chemotherapy and PICC for the patients who need short chemotherapy cycle and live close to the hospital.
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Affiliation(s)
- Tian-Tian Tang
- Breast Center of the Fourth Hospital of Hebei Medical University, No. 169, Tianshan Street, Shijiazhuang, Hebei Province, China
| | - Lei Liu
- Breast Center of the Fourth Hospital of Hebei Medical University, No. 169, Tianshan Street, Shijiazhuang, Hebei Province, China
| | - Chun-Xiao Li
- Breast Center of the Fourth Hospital of Hebei Medical University, No. 169, Tianshan Street, Shijiazhuang, Hebei Province, China
| | - Yun-Tao Li
- Breast Center of the Fourth Hospital of Hebei Medical University, No. 169, Tianshan Street, Shijiazhuang, Hebei Province, China
| | - Tao Zhou
- Breast Center of the Fourth Hospital of Hebei Medical University, No. 169, Tianshan Street, Shijiazhuang, Hebei Province, China
| | - Hai-Ping Li
- Breast Center of the Fourth Hospital of Hebei Medical University, No. 169, Tianshan Street, Shijiazhuang, Hebei Province, China
| | - Jianxin Wang
- Breast Center of the Fourth Hospital of Hebei Medical University, No. 169, Tianshan Street, Shijiazhuang, Hebei Province, China.
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