Cephalic Vein Cut-down for Totally Implantable Central Venous Access Devices With Preoperative Ultrasonography by Surgical Residents

Overview

Journal In Vivo

Specialty Oncology

Date 2019 Oct 31

PMID 31662541

Citations 5

Authors

Shintaro Hashimoto

Ryota Otsubo

Masahiro Adachi

Ryoichiro Doi

Kenichiro Shibata

Isao Sano

Yoshihito Shibata

Takayuki Nakazaki

Hideki Taniguchi

Takeshi Nagayasu

Affiliations

Soon will be listed here.

Abstract

Background/aim: Cephalic vein (CV) cut-down for totally implantable central venous access devices (TICVADs) is not frequently used due to its low success rate. We compared the outcomes of CV cut-down using preoperative ultrasonography (US) performed by experienced surgeons versus surgical residents.

Patients And Methods: From December 2015 to December 2017, 10 surgeons implanted 212 TICVADs using CV cut-down with preoperative US. The surgeons were divided into two groups of five each: surgical residents (Group A, n=124 procedures) and experienced surgeons (Group B, n=88 procedures). Duration of operation time, completion rate, and complications were retrospectively analyzed.

Results: The completion rate was significantly higher in Group A (98.4% versus 92.0%, p=0.04). Duration of operation time (45.2±14.5 versus 42.0±13.1 minutes, p=0.22), rates of early complications (1.6% versus 1.1%, p=0.77) and late complications (3.2% versus 2.3%, p=0.68) were equivalent between the two groups. No fatal complications occurred in either group.

Conclusion: CV cut-down can be safely performed by surgical residents under the use of preoperative US.

Citing Articles

Matching intraoperative teaching and learning for medical undergraduates via modified briefing-intraoperative teaching-debriefing (BID) model.

Chang Y, Chen N, Huang S, Lai C, Chen C, Chang T Sci Rep. 2023; 13(1):13732.

PMID: 37612418 PMC: 10447542. DOI: 10.1038/s41598-023-40755-9.

Safety of Insertion of Percutaneous Totally Implantable Central Venous Access Devices by Surgical Residents.

Obuchi K, Imaizumi K, Kasajima H, Kurushima M, Umehara M, Tsuruga Y In Vivo. 2022; 36(2):985-993.

PMID: 35241560 PMC: 8931890. DOI: 10.21873/invivo.12791.

Forty years after the first totally implantable venous access device (TIVAD) implant: the pure surgical cut-down technique only avoids immediate complications that can be fatal.

Toro A, Schembari E, Fontana E, Di Saverio S, Di Carlo I Langenbecks Arch Surg. 2021; 406(6):1739-1749.

PMID: 34109472 PMC: 8481188. DOI: 10.1007/s00423-021-02225-6.

Long-Term Results of a Standard Algorithm for Intravenous Port Implantation.

Wu C, Fu J, Wen C, Chiu C, Hsieh M, Liu Y J Pers Med. 2021; 11(5).

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Comparison of Central Venous Port Procedures Between Puncture . Cut-down and Residents . Senior Surgeons.

Otsubo R, Yano H, Matsumoto M, Tanaka A, Nonaka T, Hidaka S In Vivo. 2021; 35(2):1197-1204.

PMID: 33622921 PMC: 8045093. DOI: 10.21873/invivo.12369.

References

Schreckenbach T, Munch I, El Youzouri H, Bechstein W, Habbe N . The Safety Level of Total Central Venous Access Port Implantation Performed by Residents. J Surg Educ. 2018; 76(1):182-192. DOI: 10.1016/j.jsurg.2018.07.005. View

Sulek C, Blas M, Lobato E . A randomized study of left versus right internal jugular vein cannulation in adults. J Clin Anesth. 2000; 12(2):142-5. DOI: 10.1016/s0952-8180(00)00129-x. View

Haygood T, Malhotra K, Ng C, Chasen B, McEnery K, Chasen M . Migration of central lines from the superior vena cava to the azygous vein. Clin Radiol. 2011; 67(1):49-54. DOI: 10.1016/j.crad.2011.05.011. View

Biffi R, Orsi F, Pozzi S, Pace U, Bonomo G, Monfardini L . Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial. Ann Oncol. 2009; 20(5):935-40. DOI: 10.1093/annonc/mdn701. View

Matiotti-Neto M, Eskander M, Tabatabaie O, Kasumova G, Bliss L, Ng S . Percutaneous Cut-Down Technique for Indwelling Port Placement. Am Surg. 2018; 83(12):1336-1342. View

Cavallaro G, Sanguinetti A, Iorio O, DErmo G, Polistena A, Avenia N . Ultrasound-guided vein puncture versus surgical cut-down technique in totally implantable venous access devices (TIVADS): a prospective comparative study on safety, efficacy andcomplications. Int Surg. 2014; 99(4):475-8. PMC: 4114383. DOI: 10.9738/INTSURG-D-14-00008.1. View

Kock H, Pietsch M, Krause U, Wilke H, Eigler F . Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port systems. World J Surg. 1998; 22(1):12-6. DOI: 10.1007/s002689900342. View

Tsai Y, Ku Y, Chen S, Huang W, Lu C, Tsao C . Right- and left-subclavian vein port-a-cath systems: comparison of complications. Eur Surg Res. 2012; 49(2):66-72. DOI: 10.1159/000339308. View

Debourdeau P, Farge D, Beckers M, Baglin C, Bauersachs R, Brenner B . International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost. 2012; 11(1):71-80. DOI: 10.1111/jth.12071. View

10.

Otsubo R, Hatachi T, Shibata K, Yoshida T, Watanabe H, Oikawa M . Evaluation of totally implantable central venous access devices with the cephalic vein cut-down approach: Usefulness of preoperative ultrasonography. J Surg Oncol. 2015; 113(1):114-9. DOI: 10.1002/jso.24100. View

11.

Cavallaro G, Iorio O, Iossa A, De Angelis F, Avallone M, Massaro M . A prospective evaluation on external jugular vein cut-down approach for TIVAD implantation. World J Surg Oncol. 2015; 13:243. PMC: 4534022. DOI: 10.1186/s12957-015-0663-x. View

12.

Jablon L, Ugolini K, Nahmias N . Cephalic vein cut-down verses percutaneous access: a retrospective study of complications of implantable venous access devices. Am J Surg. 2006; 192(1):63-7. DOI: 10.1016/j.amjsurg.2005.11.012. View

13.

Chang H, Hsieh C, Hsieh H, Chen T, Chen C, Chan D . An alternative technique for totally implantable central venous access devices. A retrospective study of 1311 cases. Eur J Surg Oncol. 2005; 32(1):90-3. DOI: 10.1016/j.ejso.2005.09.004. View

14.

Kagawa T, Ueyama S, Kobayashi T, Okabayashi H, Kuroda S, Fujiwara T . A novel "shrug technique" for totally implantable venous access devices via the external jugular vein: A consecutive series of 254 patients. J Surg Oncol. 2016; 115(3):291-295. DOI: 10.1002/jso.24504. View

15.

Chang H, Hsieh H, Hsu S, Liao G, Lin C, Hsieh C . Guidewire assisted cephalic vein cutdown for insertion of totally implantable access ports. J Surg Oncol. 2007; 95(2):156-7. DOI: 10.1002/jso.20584. View

16.

Ishizuka M, Nagata H, Takagi K, Kubota K . Right internal jugular vein is recommended for central venous catheterization. J Invest Surg. 2010; 23(2):110-4. DOI: 10.3109/08941930903469342. View

17.

Di Carlo I, Cordio S, La Greca G, Privitera G, Russello D, Puleo S . Totally implantable venous access devices implanted surgically: a retrospective study on early and late complications. Arch Surg. 2001; 136(9):1050-3. DOI: 10.1001/archsurg.136.9.1050. View

18.

Povoski S . A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients. Ann Surg Oncol. 2000; 7(7):496-502. DOI: 10.1007/s10434-000-0496-9. View

19.

Marnejon T, Angelo D, Abu Abdou A, Gemmel D . Risk factors for upper extremity venous thrombosis associated with peripherally inserted central venous catheters. J Vasc Access. 2012; 13(2):231-8. DOI: 10.5301/jva.5000039. View

20.

Granziera E, Scarpa M, Ciccarese A, Filip B, Cagol M, Manfredi V . Totally implantable venous access devices: retrospective analysis of different insertion techniques and predictors of complications in 796 devices implanted in a single institution. BMC Surg. 2014; 14:27. PMC: 4024213. DOI: 10.1186/1471-2482-14-27. View