Ye XH, Cui RH, Xu L, Ye LR, Wang MJ. Effects of totally implantable venous access ports on complications and quality of life in gastrointestinal cancer chemotherapy. World J Gastrointest Surg 2025; 17(8): 109333 [DOI: 10.4240/wjgs.v17.i8.109333]
Corresponding Author of This Article
Mei-Jun Wang, Venous Nursing Specialist Clinic, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, No. 100 Minjiang Avenue, Kecheng District, Quzhou 324000, Zhejiang Province, China. qzrmyyjmsy@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2025; 17(8): 109333 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.109333
Effects of totally implantable venous access ports on complications and quality of life in gastrointestinal cancer chemotherapy
Xiao-Hui Ye, Rong-Hong Cui, Lei Xu, Ling-Rong Ye, Mei-Jun Wang
Xiao-Hui Ye, Rong-Hong Cui, Lei Xu, Ling-Rong Ye, Mei-Jun Wang, Venous Nursing Specialist Clinic, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou 324000, Zhejiang Province, China
Author contributions: Ye XH initiated the project, and designed the experiment and conducted clinical data collection; Cui RH, Xu L and Ye LR performed postoperative follow-up and recorded data; Ye XH and Wang MJ conducted a number of collation and statistical analysis and wrote the original manuscript. All authors have read and approved the final manuscript.
Institutional review board statement: This study has been approved by the Ethics Committee of the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital.
Informed consent statement: The ethics committee agreed to waive the patient's informed consent.
Conflict-of-interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: May 9, 2025 Revised: June 9, 2025 Accepted: June 24, 2025 Published online: August 27, 2025 Processing time: 108 Days and 5.1 Hours
Abstract
BACKGROUND
Central venous access is essential for administering chemotherapy in patients with gastrointestinal cancer. Peripherally inserted central catheters (PICC) and totally implantable venous access ports (TIVAP) are widely used, but comparative data regarding their impact on catheter-related complications and quality of life (QoL) remain limited.
AIM
To evaluate the impact of TIVAPs compared with PICC on catheter-related complications and QoL in patients with gastrointestinal cancer undergoing chemotherapy.
METHODS
This retrospective study included adults with gastrointestinal cancer who underwent central venous access device insertion for chemotherapy at our institution between December 2021 and December 2024. Inclusion criteria encompassed indications for intermittent intravenous chemotherapy, anticipated treatment duration of ≥ 12 weeks, an adequate preoperative hematologic profile, accessible upper body veins, and complete medical records. Patients were excluded if they had an anticipated survival of less than three months, active systemic infection, severe thrombosis or coagulopathy, communication barriers, or an urgent need for dialysis access. Patients were assigned to either the PICC or TIVAP group based on device type. Data collected included demographic variables, cancer characteristics, insertion procedure details, complications, and QoL, assessed via the EuroQol 5-Dimensions-3 levels, visual analogue scale, and the European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30.
RESULTS
A total of 346 patients were analyzed. Baseline demographic, clinical, and cancer characteristics were similar between groups. The TIVAP group demonstrated a significantly lower incidence of catheter-related complications than the PICC group, with no pneumothorax occurring in either group. QoL assessments at baseline were comparable. At one month, the TIVAP group exhibited significantly higher EuroQoL Five Dimensions health state scores and QLQ-C30 global health status scores. Multivariate analysis identified TIVAP use, catheter tip placement in the distal superior vena cava/right atrium, prophylactic antibiotic administration, and antimicrobial dressing application as independent protective factors associated with reduced complications and improved QoL.
CONCLUSION
In patients with gastrointestinal cancer undergoing chemotherapy, TIVAPs are associated with a lower incidence of catheter-related complications and improved QoL than PICCs. Optimal device selection, precise catheter tip positioning, and effective perioperative management are critical for minimizing complications and enhancing patient-reported outcomes during treatment.
Core Tip: This study demonstrates that totally implantable venous access ports (TIVAP) significantly reduce catheter-related complications and improve quality of life (QoL) compared to peripherally inserted central catheters in gastrointestinal cancer patients undergoing chemotherapy. Key findings include lower complication rates and higher EuroQol Five Dimensions and QoL Questionnaire-Core 30 scores in the TIVAP group, underscoring the importance of optimal device selection for enhancing patient outcomes.
