Long-term venous access insertion: 'the learning curve'.


BACKGROUND:The central venous access port device (CVAPD) provides reliable vascular access and is used for delivery of fluids and for obtaining blood samples. However, it can carry some intra- and post-operative complications such as thrombosis, pneumothorax, catheter fracture and port malposition. This article describes one surgeon's experience over a 16-year period and strategies to avoid complications. METHODS:The data were prospectively collected from 1996 to 2012 (16-year period). Collected data included age and gender of the patient, pathology, type of port used, anaesthetic type, side and site of insertion, and complications. RESULTS:A total of 958 devices were implanted. The average age of the patient was 57.8 years. Sixty-eight complications were recorded with an average complication rate of 7.1%. This rate decreased from 23% between 1996 and 1997 to 3.6% from 2010 to 2013. Venous thrombosis was the main source of complications with an incidence of 2.5%. This complication occurred in seven of the first 86 patients (8.1%, 1996-1998) and decreased to 1.9% between 2000 and 2013. Twenty infections (2%), five pneumothoraces secondary to insertion (0.5%), one port malposition (0.1%) and three fractures of the catheter (0.3%) occurred over the 16 years. CONCLUSION:The surgeon's complications of CVAPD insertion requiring removal or revision of the port were considerably reduced as the surgeon's experience increases. It is suggested that all surgeons whose practice includes CVAPD insertion will have an initial learning curve, and strategies described in this paper may help decrease the number of complications.


ANZ J Surg


ANZ journal of surgery


Fosh B,Canepa M,Eaton M




Has Abstract


2016-12-01 00:00:00












  • Total knee replacement in the morbidly obese: a literature review.

    abstract:BACKGROUND:The 'obesity epidemic' is expected to result in an increased incidence of knee osteoarthritis and hence total knee replacements (TKRs). Reviews have demonstrated the conflicting results of TKR for all obese (body mass index (BMI) >30). The aim of this literature review was to specifically evaluate outcomes o...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Samson AJ,Mercer GE,Campbell DG

    更新日期:2010-09-01 00:00:00

  • Safety of laparoscopic appendicectomy during pregnancy: a systematic review and meta-analysis.

    abstract:BACKGROUND:Acute appendicitis is the most common non-obstetric surgical presentation during pregnancy. There were concerns that laparoscopic appendicectomy increases the risk of foetal loss compared to an open approach. Therefore, with recent advances in perioperative care, it is likely the risk has changed. Here, we p...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,meta分析


    authors: Chakraborty J,Kong JC,Su WK,Gourlas P,Gillespie C,Slack T,Morris B,Lutton N

    更新日期:2019-11-01 00:00:00

  • Long-term outcome of portomesenteric vein invasion and prognostic factors in pancreas head adenocarcinoma.

    abstract:BACKGROUND:The purpose of this study was to clarify the post-operative prognosis of pancreatic head cancer with pathologic portal vein (PV) or superior mesenteric vein (SMV) invasion. METHODS:From May 1995 to December 2009, preoperative, intra-operative and post-operative data from 276 patients who underwent pancreati...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Jeong J,Choi DW,Choi SH,Heo JS,Jang KT

    更新日期:2015-04-01 00:00:00

  • Influence of local recurrence on survival in patients with rectal cancer.

    abstract:BACKGROUND:Recent trials on rectal cancer have demonstrated significant improvements in local recurrence without improvements in overall survival. The aim of this paper was to define the influence of local recurrence on survival in a prospective series of patients who underwent R0 or R1 resections for rectal cancer. M...

    journal_title:ANZ journal of surgery

    pub_type: 临床试验,杂志文章


    authors: Platell C,Spilsbury K

    更新日期:2014-01-01 00:00:00

  • Tumour cell frequency in pleural lavage in cases with stage I epidermoid lung cancer with no visceral pleural involvement.

    abstract:BACKGROUND:The presence of tumour cells in the pleural lavage of lung cancer patients with no malignant pleural effusion is a negative prognosticator. In the present study we aimed to determine the lowest frequency of positive pleural lavage in lung cancer. METHODS:The study included 26 consecutive patients who underw...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Oguzkaya F,Akçali Y,Bilgin M,Haberal A,Akgün H

    更新日期:2005-05-01 00:00:00

  • Warm-up before laparoscopic surgery is not essential.

    abstract:BACKGROUND:Several recent studies have suggested that warming up prior to surgery may improve surgical performance. The purpose of this study was to investigate whether warming up prior to laparoscopic surgery improves surgical performance or reduces surgery duration. METHODS:Between August 2011 and January 2012, a ra...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Weston MK,Stephens JH,Schafer A,Hewett PJ

    更新日期:2014-03-01 00:00:00

  • Therapeutic embolization in the treatment of recurrent haemarthrosis following knee arthroplasty.

    abstract::Recurrent spontaneous haemarthrosis after knee arthroplasty occurs in less than 1% of cases, commonly thought to be the result of impingement of hypertrophic vascular synovium or fat pads, and exacerbated by anti-coagulation or anti-platelet therapy. Traditional treatment comprises an initial period of rest followed b...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Tat-Sing Law M,McClure DN

    更新日期:2010-04-01 00:00:00

  • Can pathological reports of rectal cancer provide national quality indicators?

    abstract:BACKGROUND:Rectal cancer care has become increasingly complex and requires accurate information. The pathology report is a vital tool for accessing information to gauge a patient's prognosis and to guide treatment decisions. The aim of this study was to assess the quality of histopathological reporting and surgery for ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Keane C,Lin AY,Kramer N,Bissett I

    更新日期:2018-09-01 00:00:00

  • Use of a retrograde femoral nail in a patient with McCune-Albright syndrome.

    abstract::McCune-Albright Syndrome is a rare condition characterized by endocrine abnormalities, precocious puberty, pigmented skin lesions and polyostotic fibrous dysplasia with consequent fractures and limb deformity. Patients with this syndrome might have had multiple operations on a limb and might also have extensive intern...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Garvan JD,Trantalis JN

    更新日期:2003-12-01 00:00:00

  • Diagnosis and surgical treatment of nipple adenoma.

    abstract:BACKGROUND:Nipple adenoma is a rare and benign type of breast tumour. Because of the lack of proper understanding, it is easily overlooked and misdiagnosed by doctors. The aim of the study is to improve clinicians' awareness of the disease. METHODS:Evaluation of the complaints such as blood discharge or nodules on the...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Wang C,Wang X,Ma R

    更新日期:2015-06-01 00:00:00

  • Peritoneal carcinomatosis from colorectal cancer and small bowel cancer treated with peritonectomy.

    abstract:BACKGROUND:This study aims to assess the survival of patients who underwent peritonectomy, to assess the morbidity and mortality associated with the procedure and to review the published reports on the survival of patients with peritoneal spread of colorectal cancer (CRC). METHODS:Peritonectomy involves resection of a...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Shehata M,Chu F,Saunders V,Kam PC,Links M,Morris DL

    更新日期:2006-06-01 00:00:00

  • Evaluation of fresh frozen plasma usage at a tertiary care hospital in North India.

    abstract:BACKGROUND:Concerns regarding transfusion-transmitted infections and non-availability of blood components in developing nations, make it crucial to optimize fresh frozen plasma (FFP) transfusions and reduce wastage. METHODS:A concurrent prospective study of FFP usage was carried out in a tertiary care hospital in nort...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Chaudhary R,Singh H,Verma A,Ray V

    更新日期:2005-07-01 00:00:00

  • Change in serum albumin level predicts short-term complications in patients with normal preoperative serum albumin after gastrectomy of gastric cancer.

    abstract:BACKGROUND:The purpose of this study was to evaluate the correlation between serum albumin level change (ΔALB) and post-operative complications in patients with normal preoperative serum albumin after gastrectomy of gastric cancer. METHODS:A total of 193 patients undergoing curative (R0) gastrectomy from September 201...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Ai S,Sun F,Liu Z,Yang Z,Wang J,Zhu Z,Du S,Guan W

    更新日期:2019-07-01 00:00:00

  • Developmental anomaly of the inferior vena cava.

    abstract::Despite the many possible modes of presentation, congenital anomalies of the inferior vena cava are increasingly being found in asymptomatic patients. Although plain chest radiography may reveal enough suggestive signs, the diagnosis is usually confirmed by ultrasound, computed tomography and magnetic resonance imagin...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Sandercoe GD,Brooke-Cowden GL

    更新日期:2003-05-01 00:00:00

  • Acute epiglottitis in adults: the Royal Melbourne Hospital experience.

    abstract:BACKGROUND:To examine the common presentations and management of acute epiglottitis in adults. METHOD:Retrospective clinical study of 17 consecutive adult patients who presented to the Royal Melbourne Hospital between January 1988 and December 2000 was undertaken. RESULTS:The mean patient age was 47 years (range 20-8...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Wong EY,Berkowitz RG

    更新日期:2001-12-01 00:00:00

  • Trends in embolectomy of the extremities: a population-based study.

    abstract:BACKGROUND:There is anecdotal evidence that fewer brachial and femoral embolectomies are being carried out. This may be because of the greater use of anticoagulation in patients with atrial fibrillation. The aim of the present study was to assess community-wide temporal trends in embolectomy of the extremities and of w...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Ponosh S,Broadhurst R,Semmens J,Norman PE

    更新日期:2008-07-01 00:00:00

  • Two-stage brachiobasilic arteriovenous fistula for chronic haemodialysis access.

    abstract:BACKGROUND:Many haemodialysis patients are unable to have or maintain distal upper limb arteriovenous (AV) fistulas because of inadequate veins or arteries and therefore require more proximal access. We have reviewed our experience with a two-stage brachiobasilic AV haemodialysis fistula fashioned in the arm. METHODS:...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Francis DM,Lu Y,Robertson AJ,Millar RJ,Amy J

    更新日期:2007-03-01 00:00:00

  • Adenoid cystic carcinoma of the trachea: a long-term problem.

    abstract::Adenoid cystic carcinoma of the trachea, although rare, is the second most common primary tumour of the trachea. It is a slow-growing tumour found in younger patients than the more common squamous cell carcinoma and is relatively resistant to treatment, but metastasizes late in the course of disease and even in unrese...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Clough A,Clarke P

    更新日期:2006-08-01 00:00:00

  • Parathyroid hormone venous sampling prior to reoperation for primary hyperparathyroidism.

    abstract:BACKGROUND:The surgical cure rate for primary hyperparathyroidismis greater than 95%. For those who have recurrent or persistent disease, preoperative localization improves reoperation success rates. Selective parathyroid venous sampling (SPVS) for intact parathyroid hormone is particularly useful when non-invasive loc...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Estella E,Leong MS,Bennett I,Hartley L,Wetzig N,Archibald CA,Harper JS,Cuneo RC

    更新日期:2003-10-01 00:00:00

  • Changing pattern of adrenalectomy at a tertiary referral centre 1970-2000.

    abstract:BACKGROUND:In 1987, a report from this unit described the changing indications for open adrenalectomy over a 15-year period. The indications for adrenalectomy had switched from it being the principal therapeutic procedure used in advanced breast cancer in the early 1970s, to being predominately performed for Cushing's ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Sidhu S,Bambach C,Pillinger S,Reeve T,Stokes G,Robinson B,Delbridge L

    更新日期:2002-07-01 00:00:00

  • Comparison of lipase and amylase for diagnosing post-operative pancreatic fistulae.

    abstract:BACKGROUND:To ascertain if post-operative drain fluid lipase is superior to amylase in routinely detecting clinically significant post-operative pancreatic fistulae (POPF). METHOD:Between January 2015 and March 2016 data were collected on all patients undergoing pancreatic surgery at a regional referral centre. Routin...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Griffith D,Hanna T,Wong K,Reece-Smith A,Aroori S,Bowles M,Stell D,Briggs C

    更新日期:2018-06-07 00:00:00

  • How could management of rectoceles be optimized?

    abstract::A posterior vaginal wall prolapse, also known as a rectocele, is a common condition and is an outpouching of the posterior vaginal wall and anterior rectal wall into the lumen of the vagina.1-5 Although more common in parous women, rectoceles of over 1 cm in size have been demonstrated in over 40% of nulliparous women...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Goh JT,Tjandra JJ,Carey MP

    更新日期:2002-12-01 00:00:00

  • Progress towards near-zero 90-day mortality: 388 consecutive hepatectomies over a 16-year period.

    abstract:BACKGROUND:Hepatectomy has been the gold standard procedure for curative treatment of benign and malignant hepatobiliary lesions for over a century. The aim of this study is to report on the 16-year experience of a single institution. METHODS:All patients admitted to The Queen Elizabeth Hospital, South Australia, for ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Liu J,Reid J,Leopardi L,Edwards S,Trochsler M,Maddern G

    更新日期:2019-09-01 00:00:00

  • Sensation recovery improved by great auricular nerve preservation in parotidectomy: a prospective double-blind study.

    abstract:BACKGROUND:The great auricular nerve (GAN) is frequently sacrificed during parotidectomy and causes sensory disturbance of the auricle. Our study is to investigate whether GAN preservation can improve the sensory recovery. METHODS:Patients undergoing superficial or total conservative parotidectomy for benign tumours w...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Suen DT,Chow TL,Lam CY,Wong ES,Lam SH

    更新日期:2007-05-01 00:00:00

  • Laying open (deroofing) and curettage of sinus as treatment of pilonidal disease: a systematic review and meta-analysis.

    abstract:BACKGROUND:Laying open (deroofing, not excision) and curettage of the sinus is a minimally invasive procedure to treat pilonidal disease. A consensus on its efficacy and outcomes has not been reached. We reviewed and meta-analysed the efficacy of this procedure. METHODS:PubMed, Medline, Scopus, Ovid, Cochrane central ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,meta分析,评审


    authors: Garg P,Menon GR,Gupta V

    更新日期:2016-01-01 00:00:00

  • Evaluation of a novel breast reconstruction technique using the Braxon® acellular dermal matrix: a new muscle-sparing breast reconstruction.

    abstract:BACKGROUND:Implant-based breast reconstruction is becoming increasingly popular because of the widespread adoption of acellular dermal matrix (ADM), which allows surgeons to obtain good aesthetic results with fewer operations. To develop more conservative surgical techniques, a retrospective, three-centre, proof-of-con...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Berna G,Cawthorn SJ,Papaccio G,Balestrieri N

    更新日期:2017-06-01 00:00:00

  • Extended medial gastrocnemius myocutaneous flap in repair of the quadriceps extension mechanism.

    abstract::The gastrocnemius muscle is versatile in flap repair of defects from anterior knee to lower leg. We describe a case of extensor reconstruction using an extended medial gastrocnemius myocutaneous flap. A medial gastrocnemius flap was raised distal to its musculotendinous insertion. At its point of rotation, it was anch...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Warrier SK,Mah E,Morrison WA

    更新日期:2006-12-01 00:00:00

  • Comparative analysis of emergency general surgery on-call structure and its impact on emergency appendicectomy outcomes.

    abstract:BACKGROUND:In Australia, there has been a shift from the traditional 'on-call' surgical model to the 'acute surgical unit' (ASU) model to improve outcomes in acute general surgery. Using emergency appendicectomy as a standardized procedure, we aimed to identify the different patterns of care between these on-call struc...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Gounder J,Dissanayake B,Burstow MJ,Yuide PJ,Naidu S,Lancashire RP,Chua TC

    更新日期:2021-01-18 00:00:00

  • Clinical outcomes and safety of distal biceps repair using a modified entry point.

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    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Baba M,Leon JV,Symes M,Dorrestijn O,Young A,Cass B

    更新日期:2017-05-01 00:00:00

  • The annual scientific conference: what does the future hold?

    abstract::It is now expected that medical practitioners around the world will engage in ongoing professional development. Many Colleges, medical associations and societies have made completion of appropriate continuing professional development (CPD) mandatory and medical registration in some jurisdictions is predicated on parti...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Hollands M,Miles C

    更新日期:2009-03-01 00:00:00