Very often I find myself discussing about the usefulness of the installation of a port-a-cath with the patient and his family members.
What is it? It is a device implanted beneath the skin with deep cannulation of a vein that allows to always have a central venous access.
Generally, the inner cannula is silicon and the subcutaneous tank is titanium. It is accessible through the skin with the needle and is useful not only for the infusion of chemotherapeutic agents, but for other substances too, including parenteral nutrition and infusion of substances of support.
As you can easily understand, the port-a-cath is very useful for patients in a terminal stage of illness. Moreover, the infusion of chemotherapic agents on peripheral veins may lead to local damage (extravasation or phlebitis), therefore the implantation of a port-a-cath is absolutely advisable.
The intervention of positioning is performed under local anesthesia in day-surgery, and it takes little time. Very important is the antibiotic cover after surgery, because the skin is incised locally.
The port-a-cath is then completely beneath the skin and from the outside it isn't visible or obvious. The incision for positioning is quite small, and the proper management of the device limits the possibility of infection.
The periodic cleaning (with saline and heparin) may allow the device to keep working for a virtually unlimited time. The removal is possible at any time.
Dr. Carlo Pastore