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Table of Contents
Year : 2021  |  Volume : 4  |  Issue : 4  |  Page : 770

Authors' reply to Kothari and Niyogi et al.

1 Department of Surgical Oncology, Malabar Cancer Centre, Kannur, Kerala, India
2 Department of Onco-Anaesthesiology, Malabar Cancer Centre, Kannur, Kerala, India

Date of Submission15-Nov-2021
Date of Decision23-Nov-2021
Date of Acceptance28-Nov-2021
Date of Web Publication29-Dec-2021

Correspondence Address:
Nizamudheen Mangalassery Pareeekutty
Department of Surgical Oncology, Malabar Cancer Centre, Moozhikkara PO, Thalassery, Kannur - 670 103, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/crst.crst_288_21

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How to cite this article:
Pareeekutty NM, Chandveettil J. Authors' reply to Kothari and Niyogi et al. Cancer Res Stat Treat 2021;4:770

How to cite this URL:
Pareeekutty NM, Chandveettil J. Authors' reply to Kothari and Niyogi et al. Cancer Res Stat Treat [serial online] 2021 [cited 2022 Jan 21];4:770. Available from: https://www.crstonline.com/text.asp?2021/4/4/770/334224

We thank Kothari and Niyogi et al. for their valuable comments on our article on the complications of totally implantable venous access devices published in the last issue of the journal.[1],[2],[3]

We used local anesthesia during the procedure in the majority of our patients. The patients were counseled regarding the procedure and those who expressed willingness to undergo the procedure under local anesthesia were offered the same. Apprehensive patients, children, and those who had cancer surgery clubbed with chemoport insertion received the procedure under general anesthesia. All insertions into the left internal jugular vein (IJV) were performed under general anesthesia.

As Dr. Kothari pointed out, arm port is a promising method of insertion, and increasing evidence is coming out about its safety and durability. A systematic review showed lower incidence of intraoperative complications but increased rate of procedure conversion with arm ports.[4] However, we are not experienced in using arm ports yet.

In response to the query by Niyogi et al. regarding the laterality of port insertion, we would like to clarify that we inserted ports preferentially in the right IJV. In patients who had right-sided breast cancer and underwent right mastectomy, right IJV was still accessed, the chamber was placed in front of the chest on the left side, and the catheter was tunneled across to the insertion site. In case of bilateral breast cancer, the chamber was placed on the side where the breast was conserved and in case of bilateral mastectomy, on the side of the neck posteriorly or front of the chest more medially. Only if the right IJV was not suitable for insertion due to thrombus or infection, the left IJV was selected for cannulation.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Kothari RK. Long-term venous access devices: A lifeline for patients with cancer. Cancer Res Stat Treat 2021;4:769-70.  Back to cited text no. 1
  [Full text]  
Niyogi D, Tiwari V. Totally implantable venous access devices: Handle with care! Cancer Res Stat Treat 2021;4:768-9.  Back to cited text no. 2
Chandveetil J, Kattepur A, Pareekutty NM, Alapatt JJ, Mathiyazhakan AR, Kumbakara R, et al. Totally implantable venous access devices in cancer chemotherapy, retrospective analysis of 8421 catheter days in a tertiary cancer centre. Cancer Res Stat Treat 2021;4:449-55.  Back to cited text no. 3
Li G, Zhang Y, Ma H, Zheng J. Arm port vs. chest port: A systematic review and meta-analysis. Cancer Manag Res 2019;11:6099-112.  Back to cited text no. 4


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