All about Chemoports
A chemoport has a small round metal chamber (portal) with a rubber top (septum) and a flexible tube (catheter). It is placed completely under the skin on the chest below the collar bone. A catheter threads under the skin from the metal chamber into a large vein near the right chamber of the heart. Intravenous (IV) medicines and treatments can be given directly into the bloodstream through the port using a special type of needle.
When do we need a Chemoport in cancer treatment?
A chemo-port is used when a person needs intravenous (IV) access to receive fluids or drugs over a long period of time and the small veins in the body are thrombosed and can no longer be used.
Benefits of Chemoport
The most important benefit of chemoport is that it reduces the number of needle sticks.
- Can stay in the vein for a long period of time
- Reduces discomfort because IV therapy can be given more easily
- Does not require a dressing once the skin has healed
- Prevents the “burning” sensation sometimes felt when getting drugs by other IV methods
- Does not restrict activity – You can bathe, exercise, swim and play once the incision heals and the needle is not in place. It requires no care at home
How is Chemoport placed?
The chemo port is placed in the operating room under general or local anesthesia.
- The doctor makes a small cut in the skin below the collarbone where the port is placed and catheter introduced in a vein in the lower part of neck.
- The catheter tip is placed in a large vein in the neck under ultrasound guidance and threaded just above the right chamber of the heart.
- The other end of the catheter is tunnelled under the skin and attached to the portal.
- Fluid is injected into the portal to ensure it is working correctly.
- The portal is then placed in a small pocket under the skin in the chest and stitched to underlying tissue.
- Absorbable stitches are applied and wound dressed
- An x-ray is done to confirm catheter tip position.
When can we start using a chemoport?
A chemo port may be used, often the same day or the next morning. The skin may be tender around the incisions for 1–2 days after the port is placed. The insertion site usually heals in next 5-7 days. The sutures at insertion site are absorbable within 12-15 days.
How a chemoport works?
Because the port is under the skin, it must be accessed using a special needle (Huber needle). When IV therapy is needed:
- The skin is thoroughly cleaned with antiseptic. The needle is inserted through the skin and the rubber top of the portal.
- The needle is attached to a short length of tubing that hangs down the front of the chest.
- A small dressing is used to cover and protect the needle.
- The fluid or medicine flows through the needle into the port, then through the catheter and into the blood.
- After the treatment is over, the needle is removed.
- Infection in the skin at the exit site or in blood - Some infections can be treated with antibiotics.
- Blood clots in the catheter or vein – The catheter may be flushed with a drug to try and dissolve the clot.
- Subcutaneous port moves and irritates the vein- The port may be removed.
- In case the port has severe infection or is blocked due to blood clots, rarely we need to remove the ports.
Caring for a chemoport
Because a subcutaneous port is completely under the skin, it needs very little care.
- The skin at the injection site needs to be washed as normal.
- A bandage is not needed when a needle is not in place.
- Check the site daily for any redness, swelling or other signs of infection.
Removing a chemoport
A subcutaneous port will be removed when IV therapy is no longer needed. This is done in the operating room under local anesthesia, usually on outpatient basis.
When to call the doctor
Call the doctor if:
- There is any redness, tenderness, bruising or drainage at or near the port injection site
- The person has a fever, aches or flu-like symptoms
- The port moves or there is swelling, tingling or pain at or near the port injection site.
Dr Ashish Goel
Associate Director, Surgical Oncology
Jaypee Hospital, Sector 128, Noida, Delhi NCR.