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Totally Implantable Venous Access Device for Long Term Parenteral Nutrition in a Patient with High Output Enterocutaneous Fistula Due to Advanced Malignancy
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/></div></noscript> <!-- /Yandex.Metrika counter --> <!-- Matomo --> <!-- End Matomo Code --> <title>Totally Implantable Venous Access Device for Long Term Parenteral Nutrition in a Patient with High Output Enterocutaneous Fistula Due to Advanced Malignancy</title> <meta name="description" content="Totally Implantable Venous Access Device for Long Term Parenteral Nutrition in a Patient with High Output Enterocutaneous Fistula Due to Advanced Malignancy"> <meta name="keywords" content="parenteral nutrition, totally implantable venous access device, long term venous access, interventions in anesthesiology"> <meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1, maximum-scale=1, user-scalable=no"> <meta charset="utf-8"> <link href="https://cdn.waset.org/favicon.ico" type="image/x-icon" rel="shortcut icon"> <link href="https://cdn.waset.org/static/plugins/bootstrap-4.2.1/css/bootstrap.min.css" rel="stylesheet"> <link 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non-resectable abdominal malignancy patients, though is frequently neglected aspect. Non-Healing high output Entero-cutaneous fistulas sometimes require long term parenteral nutrition, to take care of catabolism and replacement of nutrients. We present a case of inoperable pancreatic malignancy with high output entero-cutaneous fistula, which was provided parenteral nutritional support with the use of Totally Implantable Venous Access Device (TIVAD). Method and Results: 55 year old man diagnosed with carcinoma pancreas had developed high entero-cutaneous fistula. His tumor was found to be inoperable and was on total parenteral nutrition through routine central line. This line was difficult to maintain as he required it for a long term TPN. He was planned to undergo Totally Implantable Venous Access Device (TIVAD) implantation. 8Fr single lumen catheter with Groshong non-return Valve (Bard Access Systems, Inc. USA) was inserted through right internal jugular vein, under fluoroscopic guidance. The catheter was tunneled subcutaneously and brought towards infraclavicular pocket, cut at appropriate length and connected to port and locked. Port was sutured in floor of pocket. Free flow of blood aspirated, flushed with heparinized saline. There was no kink observed in entire length of catheter under fluoroscopy. Skin over infraclavicular pocket was sutured. Long term catheter care and associated risks were explained to patient and relatives. Patient continued to receive total parenteral nutrition as well as other supportive therapy though TIVAD for next 6 weeks, till his demise. Conclusion: TIVADs are standard of care for long term venous access solutions in cancer patients requiring chemotherapy. In this case, we extended its use for providing parenteral nutrition and other supportive therapy. TIVADs can be implanted in advanced cancer patients for providing venous access solution required for various palliative treatments and medications. This will help in improving quality of life and satisfaction amongst terminally ill cancer patients. <iframe src="https://publications.waset.org/abstracts/79111.pdf" style="width:100%; height:400px;" frameborder="0"></iframe> <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=parenteral%20nutrition" title="parenteral nutrition">parenteral nutrition</a>, <a href="https://publications.waset.org/abstracts/search?q=totally%20implantable%20venous%20access%20device" title=" totally implantable venous access device"> totally implantable venous access device</a>, <a href="https://publications.waset.org/abstracts/search?q=long%20term%20venous%20access" title=" long term venous access"> long term venous access</a>, <a href="https://publications.waset.org/abstracts/search?q=interventions%20in%20anesthesiology" title=" interventions in anesthesiology"> interventions in anesthesiology</a> </p> <a href="https://publications.waset.org/abstracts/79111/totally-implantable-venous-access-device-for-long-term-parenteral-nutrition-in-a-patient-with-high-output-enterocutaneous-fistula-due-to-advanced-malignancy" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/79111.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">247</span> </span> </div> </div> </div> </main> <footer> <div id="infolinks" class="pt-3 pb-2"> <div class="container"> <div style="background-color:#f5f5f5;" class="p-3"> <div class="row"> <div class="col-md-2"> <ul class="list-unstyled"> About <li><a href="https://waset.org/page/support">About Us</a></li> <li><a href="https://waset.org/page/support#legal-information">Legal</a></li> <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/WASET-16th-foundational-anniversary.pdf">WASET 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