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












  • Systematic review of the impact of sacral neuromodulation on clinical symptoms and gastrointestinal physiology.

    abstract:BACKGROUND:Sacral neuromodulation (SNM) has emerged as a treatment option for faecal incontinence (FI). However, its objective effect on symptoms and anorectal function is inconsistently described. This study aimed to systematically review the impact of SNM on clinical symptoms and gastrointestinal physiology in patien...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Mirbagheri N,Sivakumaran Y,Nassar N,Gladman MA

    更新日期:2016-04-01 00:00:00

  • Anastomotic leaks in stage IV colorectal cancer.

    abstract:BACKGROUND:The purpose of this study was to determine the anastomotic leak rate for colorectal cancer resections in patients with metastases (compared to those without), and to determine the impact of anastomotic leaks on survival. METHODS:This is a retrospective analysis of all patients who underwent resection and pr...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Ng SC,Stupart D,Bartolo D,Watters D

    更新日期:2018-09-01 00:00:00

  • Radioactive iodine ablation post differentiated thyroid cancer surgery: an analysis of use and impact of the American Thyroid Association guidelines.

    abstract:BACKGROUND:The 2009 American Thyroid Association (ATA) three-tiered risk stratification, and its updated version in 2015, provided clearer guidance on the use of radioactive iodine (RAI) ablation in differentiated thyroid cancer (DTC) patients. This study examines the impact of these guidelines on RAI use in our instit...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Sia Y,Dave RV,Nour D,Miller JA,Skandarajah AR,Tasevski R

    更新日期:2019-11-01 00:00:00

  • Does knee position during wound closure alter patella height following total knee arthroplasty?

    abstract:BACKGROUND:Patella infera is a known complication of total knee arthroplasty, and the method of soft tissue closure is a possible contributing factor. The aim of our study was to evaluate the effect of knee position during surgical closure of capsule, subcutaneous tissue and skin on patella tendon length after total kn...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Clark S,Tee L,Sutherland A

    更新日期:2019-03-01 00:00:00

  • Nephron-sparing surgery for small incidental renal cell carcinoma.

    abstract:BACKGROUND:Nephron-sparing surgery is currently an accepted treatment for renal cell carcinomas in patients with bilateral tumours, solitary kidneys and when overall renal function is impaired or at risk from medical disease. Its role in patients with a normal contralateral kidney remains controversial. METHODS:The au...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Sullivan M,Frydenberg M

    更新日期:2001-06-01 00:00:00

  • Surgical volume influences survival in patients undergoing resections for stage II colon cancers.

    abstract:BACKGROUND:There is current interest in the correlation between surgical volume and outcomes. Survival in patients with rectal cancer appears to improve when carried out by surgeons who do high volumes of procedures. A similar correlation for patients with colon cancer has never been clearly established. The aim of thi...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,多中心研究


    authors: Morris M,Platell CF

    更新日期:2007-10-01 00:00:00

  • Haemorrhagic complications of pancreaticoduodenectomy.

    abstract:BACKGROUND:Haemorrhagic complication occurs in 5-16% of patients following pancreaticoduodenectomy (PD). We report an analysis of patients with post-PD bleed, to identify predictors of bleed, predictors of survival following bleed and the management of post-PD bleed. METHODS:Two hundred and eighteen patients with peri...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Balachandran P,Sikora SS,Raghavendra Rao RV,Kumar A,Saxena R,Kapoor VK

    更新日期:2004-11-01 00:00:00

  • Familial colorectal cancer type X: polyp burden and cancer risk stratification via a family history score.

    abstract:BACKGROUND:Patients fulfilling Amsterdam-1 criteria without mismatch repair deficiency (termed familial colorectal cancer type X (FCC type X)) were reported to have lower cancer risks than classic Lynch syndrome. This study investigates the polyp and cancer burden of this population and demonstrates relationships with ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Koh PK,Kalady M,Skacel M,Fay S,McGannon E,Shenal J,Arroyo L,Toderick K,Church J

    更新日期:2011-07-01 00:00:00

  • Does an Acute Surgical Model increase the rate of negative appendicectomy or perforated appendicitis?

    abstract:INTRODUCTION:The clinical outcomes from suspected appendicitis depend on balancing the rate of negative appendicectomy (NA) with perforated appendicitis (PA). An Acute Surgical Model (ASM) was introduced at Geelong Hospital (GH) in 2011 involving a dedicated emergency general surgery theatre list every business day giv...

    journal_title:ANZ journal of surgery

    pub_type: 临床试验,杂志文章


    authors: Brockman SF,Scott S,Guest GD,Stupart DA,Ryan S,Watters DA

    更新日期:2013-10-01 00:00:00

  • Investigations and time trends in loop ileostomy reversals following anterior resections: a single Australian institution seven-years' experience.

    abstract:BACKGROUND:Currently no consensus exists regarding what pre-reversal investigations are required to assess integrity of the rectal anastomosis. The objective of this study was to compare pre-reversal assessments of anastomotic integrity and to evaluate trends that might have influenced timings for reversal. METHODS:Fr...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Taylor D,Besson A,Faragher IG,Chan STF,Yeung JM

    更新日期:2020-12-09 00:00:00

  • Tensile strength of surgical knots in abdominal wound closure.

    abstract::Abdominal wound dehiscence is a surgical catastrophe that can be attributed to patients or technical factors. The technical properties of the monofilament sutures and knots that are commonly used in abdominal closure are poorly understood. The aim of this study was to compare the tensile strength of monofilament sutur...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Fong ED,Bartlett AS,Malak S,Anderson IA

    更新日期:2008-03-01 00:00:00

  • Unusual case of Morgagni hernia associated with malrotation.

    abstract::Morgagni herniae are rare congenital diaphragmatic hernia, which normally present late in adult life with minimal symptoms. They are always associated with a peritoneal hernial sac, and often contain transverse colon or stomach. We present an unusual case of a Morgagni hernia containing caecum in an 81-year-old woman,...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Court FG,Wemyss-Holden SA,Fitridge R,Maddern GJ

    更新日期:2003-09-01 00:00:00

  • Factors affecting false-negative breast sentinel node biopsy in Chinese patients.

    abstract:BACKGROUND:The objective of the research was to validate our results on sentinel lymph node biopsy (SLNB) and to determine factors affecting false-negative (FN) rates of SLNB in Chinese patients with invasive breast cancers. METHODS:A retrospective study of patients with clinically node-negative invasive breast cancer...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Chok KS,Suen DT,Lim FM,Li GK,Kwong A

    更新日期:2007-10-01 00:00:00

  • Many faces of pancreaticobiliary reflux.

    abstract::Pancreaticobiliary reflux may occur either as a result of an anatomically abnormal pancreaticobiliary junction or because of a functionally impaired sphincter despite a normal radiological appearance. It is associated with a wide spectrum of biliary diseases, including gall bladder and bile duct carcinoma. Pancreatico...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Williams NE,Gundara JS,Hugh TJ,Samra JS

    更新日期:2012-06-01 00:00:00

  • Urethral syringocele: unseen but existing.

    abstract:BACKGROUND:Bulbourethral syringocele is an uncommon and under-diagnosed condition most commonly seen in the paediatric population, although there is increasing recognition in adults. Due to the difficulty in diagnosis, we report our experience of urethral syringocele in a quaternary paediatric hospital, with differing ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Saadat P,Borzi P,Patel B,Winkle D

    更新日期:2019-06-01 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

  • Quad bike injuries at an Australian regional hospital: a trauma registry review.

    abstract:BACKGROUND:Quad bikes are a prominent cause of morbidity and mortality in Australia in both agriculture and recreation. This study describes the clinical and epidemiological characteristics of quad bike injuries at the Royal Darwin Hospital (RDH). METHODS:A retrospective review of the RDH Trauma Registry for all quad ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Liddle SE,McDermott KM,Ward LM,Lim HH,Read DJ

    更新日期:2020-04-01 00:00:00

  • Blue nevus-like and blue nevus-associated melanoma: a comprehensive review of the literature.

    abstract:BACKGROUND:Malignant blue nevus, blue nevus-associated melanoma and blue nevus-like melanoma are all terms used to describe malignant melanomas arising from, in association with, or resembling blue nevi. This review is aimed at summarizing the available literature to reduce the confusion surrounding this rare malignanc...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Borgenvik TL,Karlsvik TM,Ray S,Fawzy M,James N

    更新日期:2017-05-01 00:00:00

  • Use of trastuzumab in Australia and New Zealand: results from the National Breast Cancer Audit.

    abstract:BACKGROUND:Trastuzumab increases disease-free and overall survival in HER-2-positive, early breast cancer. In 2007, the National Breast and Ovarian Cancer Centre recommended that patients with HER-2 positive cancers (node positive or node negative tumours >1 cm) be offered adjuvant trastuzumab with chemotherapy. The ai...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Whitfield R,Kollias J,De Silva P,Zorbas H,Maddern G

    更新日期:2012-04-01 00:00:00

  • Laparoscopic liver resection in cirrhotics: feasibility and short-term outcomes compared to non-cirrhotics.

    abstract:BACKGROUND:Laparoscopic liver resection (LLR) is increasingly common worldwide but its suitability in patients with cirrhosis is not clearly defined. There are minimal data in the western literature on this topic and previous work has compared LLR to open hepatectomy rather than to LLR in non-cirrhotic patients. This s...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Srinivasa S,Hughes M,Azodo IA,Adair A,Ravindran R,Harrison E,Wigmore SJ

    更新日期:2020-06-01 00:00:00

  • Parastomal hernia following minimally invasive stoma formation.

    abstract:BACKGROUND:Minimally invasive intestinal stoma formation using a laparoscopic approach or through a trephine, is widely described in published literature. The incidence of parastomal hernia (PH) following a stoma formed without formal laparotomy is not well reported. The present review aims to assess the current data a...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Carne PW,Frye JN,Robertson GM,Frizelle FA

    更新日期:2003-10-01 00:00:00

  • Complete natal cleft removal with kite incision in the treatment of extensive sacrococcygeal pilonidal sinus.

    abstract:BACKGROUND:Pilonidal sinus (PS) is a benign disease for which different treatment modalities are used, varying from non-surgical treatments to surgical treatments with flap use for big defects. High recurrence is the main problem in complicated cases. We presented complete natal cleft excision with kite incision and fa...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Ozdemir H,Unal Ozdemir Z,Sunamak O

    更新日期:2020-04-01 00:00:00

  • Post-operative outcomes in older patients: a single-centre observational study.

    abstract:BACKGROUND:Improved life-expectancies have seen increased rates of older patients undergoing surgery worldwide. These patients are at increased risk of post-operative complications. Australian evidence is limited regarding the association between age and post-operative outcomes, especially rapid response calls (RRCs) a...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Tang B,Green C,Yeoh AC,Husain F,Subramaniam A

    更新日期:2018-05-01 00:00:00

  • Functional and proteomic analysis of serum and cerebrospinal fluid derived from patients with traumatic brain injury: a pilot study.

    abstract:BACKGROUND:An enhanced fracture healing response has been reported in patients with traumatic brain injury (TBI). This has been attributed to circulating humoral factors that are thought to be proteins produced and released by the injured brain. However, these factors remain unknown. The aim of this study was to identi...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Cadosch D,Thyer M,Gautschi OP,Lochnit G,Frey SP,Zellweger R,Filgueira L,Skirving AP

    更新日期:2010-07-01 00:00:00

  • Preoperative anaemia and thrombocytopenia are associated with venous thromboembolism complications after colorectal resection.

    abstract:BACKGROUND:Earlier studies have shown that abnormal levels of haemoglobin and platelets may be associated with worse post-operative outcomes. We aim to compare the rates of venous thromboembolism (VTE), anastomotic leak and other complications in patients post-colorectal resection with normal and abnormal levels of hae...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Yeap E,Teoh WMK,Nguyen TC,Suhardja TS

    更新日期:2020-05-01 00:00:00

  • Early outcomes of implanting larger-sized grafts in deceased donor liver transplantation.

    abstract:BACKGROUND:The outcomes of large-sized graft mismatch in deceased donor liver transplantation (LT) have been rarely studied. The aim of this study was to determine whether a large-sized graft for recipient influenced the post-transplant outcomes. METHODS:A total of 273 patients undergoing LT were enrolled and divided ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Shen Z,Wang Z,Jiang Y,Wu T,Zheng S

    更新日期:2020-07-01 00:00:00

  • Prospective comparison of return of bowel function after left versus right colectomy.

    abstract:BACKGROUND:Passage of flatus and stool represents a key milestone in recovery after colonic resections. Colorectal surgeons may hold varied expectations regarding recovery rates after left- versus right-sided colectomies, but there is currently little evidence to inform post-operative care. This study prospectively com...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Yuan L,O'Grady G,Milne T,Jaung R,Vather R,Bissett IP

    更新日期:2018-04-01 00:00:00

  • Facial transplantation as an option in reconstructive surgery: no mountains too high?

    abstract:BACKGROUND:Human facial allotransplantation (FA) is a testament to the impressive progress, which was and is still happening in the field of transplantation medicine and reconstructive surgery. Like every pioneering treatment option, FA faces both the clinicians' and public opinion with a huge amount of medical and psy...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Błogowski W

    更新日期:2009-12-01 00:00:00

  • Laparoscopic revision of gastric band surgery.

    abstract:AIM:To identify the outcome of laparoscopic revision of gastric band surgery with respect to percentage of excess weight lost (%EWL). METHODS:Analysis of a prospective database was then performed and %EWL was plotted with respect to time from initial procedure and also time from revision procedure. RESULTS:All revisi...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章


    authors: Bardsley S,Hopkins G

    更新日期:2010-05-01 00:00:00

  • Extended endoscopic endonasal skull base surgery: from the sella to the anterior and posterior cranial fossa.

    abstract::Skull base surgery has gone through significant changes with the development of extended endoscopic endonasal approaches over the last decade. Initially used for the transphenoidal removal of hypophyseal adenomas, the endoscopic transnasal approach gradually evolved into a way of accessing the whole ventral skull base...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审


    authors: Oostra A,van Furth W,Georgalas C

    更新日期:2012-03-01 00:00:00