Introduction: Centrally inserted central catheter (CICC) insertion is a commonly performed procedure that may give rise to different complications. Despite the suggestion of guidelines to use ultrasound guidance (USG) for vascular access, not all centers use it systematically. The aim of this study is to illustrate the experience with ultrasound in CICC placement at a high-volume oncological center, in a country where the landmark technique is standard. Methods: Retrospective analysis of a prospective database was performed on CICC placement under USG in the Central Venous Catheter Unit of Instituto Português de Oncologia de Lisboa Francisco Gentil, from 2012 to 2015. Results: Three thousand five hundred and seventy-two procedures were recorded. From 2728 CICC placements, 1187 (43.5%) were done using USG. The majority of CICC placements were successful without immediate complications (96.1%). In 55 cases (4.6%), more than three attempts were necessary to puncture the vein. Pneumothorax occurred in 5 cases (0.4%) and arterial puncture was registered in 41 cases (3.5%). An increasing use of USG for placing CICCs was planned and observed over the years and, in the last year of the study, 67.3% of the CICC placements were with USG. Conclusions: CICC placement with USG is a safe and effective technique. Despite some resistance that is observed, these results support that it is worth following the guidelines that advocate the use of the USG in the placement of CICC.

Introduction: Pre-pectoral breast reconstruction using implant and acellular dermal matrix (ADM) has become one of the main techniques for immediate reconstruction after mastectomy, with variable approaches and complication rates reported in literature. This study aims to evaluate the early outcomes of this technique, at a single tertiary oncology center. Methods: We performed a retrospective analysis of a prospectively maintained database including women who underwent immediate pre-pectoral reconstruction with implant and ADM following mastectomy between January 2021 and August 2023. The primary outcome was reconstructive failure within 3 months, defined as the need for removal of the implant placed during the index surgery. Secondary outcomes included complications at 3 months and predictive factors for complications. Results: A total of 247 reconstructions were performed in 200 patients, 83.4% following oncological mastectomy and 16.6% after risk-reducing surgery. The median age was 49 (43–56) years; 15.5% of patients were obese and 26.5% were active smokers. Skin-sparing mastectomy was performed in 16.6% and nipple-sparing in 83.4%, with a Wise-pattern incision in 73.3%. Reconstructive failure occurred in 7.7%, with one case (0.4%) of total reconstruction loss. The overall complication rate was 14.6%—skin flap ischemia occurred in 12.6%, primary implant infection in 2.0% and bleeding in 0.8%. The reoperation rate was 8.4%. No predictive factors for complications were identified. Conclusions: In this series, including a high proportion of high-risk patients, immediate pre-pectoral reconstruction with implant and ADM appears safe, with a low rate of early complications. No predictive factors for complications were found, supporting widening its indications.