Mediastinal infusion with tracheal necrosis: an unusual complication of Port-a-cath devices.

Fiche publication


Date publication

juin 2011

Auteurs

Membres identifiés du Cancéropôle Est :
Pr FALCOZ Pierre-Emmanuel


Tous les auteurs :
Renaud S, Santelmo N, Falcoz PE, Massard G

Résumé

The Port-a-cath (PAC) is a catheter totally implanted under the skin. It is commonly used in oncology for permanent venous access. It provides a more simple way to infuse chemotherapies, antibiotics or parenteral nutrition, while offering improved comfort to patients. The usual complications of these devices (infections and catheter obstructions) are well documented. More exceptional events are catheter fractures with systemic migration, and endopleural perfusions due to a wrong positioning of the catheter. Since 1998, 10 cases of mediastinal infusion of cytotoxics have been reported. Surgical management was necessary in only two cases. We are reporting the case of a 57-year-old female suffering from a multimetastatic sigmoid adenocarcinoma. A mediastinal infusion of Folfiri and bevacizumab with a tracheal necrosis complicated the PAC use and required a latissimus dorsi myoplasty to fill up the tracheo-bronchial defect.

Référence

Interact Cardiovasc Thorac Surg. 2011 Jun;12(6):1007-9