Basilic vein variation encountered during surgery for arm vein port:A case report

BACKGROUND Venous variations are uncommon and usually hard to identify,and basilic vein variation is particularly rare.Basilic vein variation usually presents without any clinical symptoms and is often regarded as a benign alteration.This case was a patient with congenital basilic vein variation encountered during surgery for an infusion port.CASE SUMMARY We documented and analyzed an uncommon anatomical variation in the basilic vein encountered during arm port insertion.This peculiarity has hitherto remained undescribed in the literature.We offer remedial strategies for addressing this anomaly in the future and precautionary measures to circumvent its occurrence.We conducted a comprehensive review of analogous cases in the literature,offering pertinent therapeutic recommendations and solutions,with the aim of enhancing the efficacy and safety of future arm port implantations.CONCLUSION Venous variation is rare and requires detailed intraoperative and postoperative examination to ensure accuracy,so as not to affect subsequent treatment.

应用Port-Access系统行微创冠状动脉旁路移植术21例体会

目的 介绍应用Port-Access系统进行微创冠状动脉旁路移植术的体会。 方法 采用左胸小切口 (6～ 7)cm ,经股静脉插静脉管 ,经升主动脉或股动脉插动脉管 ,主动脉内球囊阻断的方法 ,行微创冠状动脉旁路移植术。 结果 本组 2 1例无手术死亡 ,无重大并发症。 结论 应用Port-Access系统进行微创冠脉搭桥手术是一种安全可靠的手术方法 ,可以避免胸骨切开 ,减轻疼痛 ,利于患者后恢复。

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time.Advantages of ports include a simple nursing process,low risk of infection and embolism,and high patient comfort.In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications,the Chinese Research Hospital Association Digestive Tumor Committee,the Chinese Association of Upper Gastrointestinal Surgeons,the Chinese Gastric Cancer Association,and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nationwide expert letter reviews and on-site seminars,and formulated an expert consensus of the operation guidelines.

Gastrointestinal stromal tumor metastasis at the site of a totally implantable venous access port insertion:A rare case report

BACKGROUND The totally implantable venous access port(TIVAP)is an important device in patients for injecting blood products,parenteral nutrition or antineoplastic chemotherapy.Metastatic spread at the site of the insertion of a TIVAP is extremely rare.CASE SUMMARY We report the case of 33-year-old male with advanced gastrointestinal stromal tumor(GIST)who underwent radical tumor resection after neoadjuvant imatinib therapy.However,a solitary GIST metastasis at the site of a TIVAP insertion developed during adjuvant imatinib treatment.Mutational analysis showed secondary mutation in KIT exon 13(V564 A),which is resistant to imatinib treatment.To our knowledge,this is the first case report of a patient with advanced GIST developing GIST metastasis at the site of a TIVAP insertion.CONCLUSION This case highlights that when a patient with advanced,high metastatic GIST requires TIVAP insertion,we should realize that there is a risk of developing tumor metastasis at the site of a TIVAP insertion.

Accidental venous port placement via the persistent left superior vena cava:Two case reports

BACKGROUND Breast cancer poses a great threat to females worldwide.There are various therapies available to cure this common disease,such as surgery,chemotherapy,radiotherapy,and immunotherapy.Implantable venous access ports(IVAP,referred to as PORT)have been widely used for breast cancer chemotherapy.Venous malformations are possible conditions encountered during PORT implantation.Persistent left superior vena cava(PLSVC)is a common superior vena cava malformation.Most patients have normal right superior vena cava without affecting hemodynamics,so patients often have no obvious symptoms.CASE SUMMARY We incidentally found that two patients had PLSVC while a PORT was implanted via the internal jugular vein.Due to chemotherapy for breast cancer,PORT was successfully implanted under the guidance of ultrasound into these 2 patients.Positive chest X-ray examination after the operation showed that the catheter ran beside the left mediastinum and the end was located in the seventh thoracic vertebra.The patients had no catheter-related complications and successfully completed the course of chemotherapy.Ultrasonography found that the ratio of PORT outer diameter to PLSVC inner diameter was less than 0.45,which was in line with the recommendations of relevant literature and operating guidelines.The purpose of this article is to introduce two rare cases and review the relevant literature.CONCLUSION Correct assessment of PLSVC status and ultrasound-guided PORT placement generally does not affect breast cancer patients chemotherapy.

Clinical Course of Lung Cancer Patients with Subcutaneously Implanted Central Venous Access Device Ports from the Time of Receiving Chemotherapy to the Endpoint of Cancer

Background: As the prognosis of lung cancer (LC) patients improves, subcutaneously implanted central venous access device ports (CV-ports) have frequently been used for continuing chemotherapy (CC) or palliative care (PC). In this study, we examined the clinical course of LC patients with subcutaneously implanted CV-ports from the time of receiving chemotherapy to the endpoint of cancer. Materials and Methods: We retrospectively reviewed the clinical data and treatment history of LC patients with subcutaneously implanted CV-ports between June 2008 and November 2013 using clinical records and a pharmacy database. Results: Of the 132 LC patients with subcutaneously implanted CV-ports, 79 (59.8%) had CV-ports for CC (the CC group) and 53 (40.2%) had CV-ports for PC (the PC group). After CV-port implantation, LC patients in the CC group received a median of two regimens with a median of 6 cycles. The median survival time of patients in the CC and PC groups was 457 and 44 days, respectively. In the CC group, the median survival time of small cell and non-small cell LC patients was 342 (95% confidence interval, 235 - 627) and 563 (95% confidence interval, 368 - 728) days, respectively. Nine patients (6.8%) had their CV-ports removed due to complications. Forty (30.3%) of the 132 enrolled patients were referred for at-home PC. The at-home death rate observed among these 40 patients was 30.0% (N = 12). Conclusion: CV-ports may contribute to seamless oncological care.

VAP血管通路在小型猪静脉糖耐量试验中的应用

目的通过VAP（vascular—access．port）血管通路来改善小型猪静脉糖耐量试验（IVGTT）结果的可靠性，减少试验过程中的应激反应，并且为小型猪IVGTT试验提供一种便捷快速且稳定的新方法。方法将12只巴马小型猪随机分为VAP血管通路植入组与正常对照组，比较两组动物在IVGTT中的差异，并评价应激指标。结果VAP组与对照组小型猪在IVGTT试验中均能出现糖耐量反应，其血清胰岛素含量变化以及趋势无统计学差异，但VAP组血糖水平在0min，60min、90min以及120min显著低于对照组（P〈0．05，P〈0．01），且在5min血糖水平显著高于正常对照组（P〈0．01）；对照组肌酶激酶（CK）水平在各时间点均显著高于VAP组（P〈0．01）；对照组促肾上腺皮质激素（ACTH）、皮质醇（CORT）在0min、15—120min时都高于vAP组，且在60～120min时差异有统计学意义（P〈0．05，P〈0．01）。结论与常规方法比较，VAP血管通路植入后小型猪在IVGTT中所受应激更小，更符合动物福利，且试验结果更加可靠稳定。