Abstract：
BACKGROUND: The widespread use of chemotherapies has increased the need for totally implantable venous access ports (TIVAPs). Previously, the subclavian puncture approach with the landmark technique was the most used implantation method; however, it has been related to early complications such as pneumothorax, hemothorax, and arterial puncture. Therefore, a safer implantation method is required. This study aimed to assess the safety and efficacy of the cephalic vein cut-down method used in our institution.
METHODS: Patients who underwent TIVAPs implantation using the cephalic vein cut-down method as the first choice between January 1, 2018, and December 31, 2020, were included in this study. We retrospectively evaluated the technical success rates, operation times, and early complications.
RESULTS: This study included 221 adult patients (men, 129; women, 92), with a mean age of 68 ± 11 years. The mean body mass index (BMI) was 21 ± 4 kg/m2. A total of 213 patients (96.4%) had malignant tumors that required chemotherapy. The mean postoperative follow-up period was 659 ± 442 days (range, 5-1,698 days). A total of 127 patients (57.5%) died during the follow-up period. The technical success rate was 86.4% (191/221). There were 30 failures, 24 of which were converted to the subclavian vein puncture approach. The mean operation time was 53 ± 21 min. Early complications were observed in 4 (1.8%) patients, corresponding to an incidence of 0.028 complications/1,000 catheter days. One patient had an unintended arterial puncture; however, it was not a result of the cephalic vein cut-down method but a secondary result of the subclavian vein puncture. No complications of pneumothorax, hemothorax, or arterial puncture were observed with the cephalic vein cut-down method.
CONCLUSIONS: This study showed that the cephalic vein cut-down method for TIVAPs had an acceptable success rate and fewer early complications than the conventional puncture techniques.
METHODS: Patients who underwent TIVAPs implantation using the cephalic vein cut-down method as the first choice between January 1, 2018, and December 31, 2020, were included in this study. We retrospectively evaluated the technical success rates, operation times, and early complications.
RESULTS: This study included 221 adult patients (men, 129; women, 92), with a mean age of 68 ± 11 years. The mean body mass index (BMI) was 21 ± 4 kg/m2. A total of 213 patients (96.4%) had malignant tumors that required chemotherapy. The mean postoperative follow-up period was 659 ± 442 days (range, 5-1,698 days). A total of 127 patients (57.5%) died during the follow-up period. The technical success rate was 86.4% (191/221). There were 30 failures, 24 of which were converted to the subclavian vein puncture approach. The mean operation time was 53 ± 21 min. Early complications were observed in 4 (1.8%) patients, corresponding to an incidence of 0.028 complications/1,000 catheter days. One patient had an unintended arterial puncture; however, it was not a result of the cephalic vein cut-down method but a secondary result of the subclavian vein puncture. No complications of pneumothorax, hemothorax, or arterial puncture were observed with the cephalic vein cut-down method.
CONCLUSIONS: This study showed that the cephalic vein cut-down method for TIVAPs had an acceptable success rate and fewer early complications than the conventional puncture techniques.
摘要：
目的：化疗的广泛使用增加了对完全植入式静脉接入端口（TIVAP）的需求。以前,使用标志性技术的锁骨下穿刺入路是最常用的植入方法；然而，它与早期并发症有关，如气胸，血胸,动脉穿刺.因此,需要一种更安全的植入方法。这项研究旨在评估我们机构中使用的头静脉切开方法的安全性和有效性。
方法：本研究包括在2018年1月1日至2020年12月31日期间使用头静脉切开方法进行TIVAP植入的患者。我们回顾性评估了技术成功率，操作次数,早期并发症。
结果：这项研究包括221名成年患者（男性，129;妇女，92),平均年龄68±11岁。平均体重指数（BMI）为21±4kg/m2。共有213例（96.4％）患有需要化疗的恶性肿瘤。术后平均随访时间为659±442天（范围，5-1698天）。共有127例患者（57.5%）在随访期间死亡。技术成功率为86.4%(191/221)。有30次失败，其中24例改行锁骨下静脉穿刺入路。平均手术时间为53±21分钟。4例（1.8%）患者出现早期并发症，对应于0.028并发症/1,000导管天的发生率。一名患者意外动脉穿刺；然而，这不是头静脉切开法的结果，而是锁骨下静脉穿刺的次要结果.无气胸并发症,血胸,或采用头静脉切开法观察动脉穿刺。
结论：这项研究表明，与常规穿刺技术相比，TIVAP的头静脉切开方法具有可接受的成功率和较少的早期并发症。
方法：本研究包括在2018年1月1日至2020年12月31日期间使用头静脉切开方法进行TIVAP植入的患者。我们回顾性评估了技术成功率，操作次数,早期并发症。
结果：这项研究包括221名成年患者（男性，129;妇女，92),平均年龄68±11岁。平均体重指数（BMI）为21±4kg/m2。共有213例（96.4％）患有需要化疗的恶性肿瘤。术后平均随访时间为659±442天（范围，5-1698天）。共有127例患者（57.5%）在随访期间死亡。技术成功率为86.4%(191/221)。有30次失败，其中24例改行锁骨下静脉穿刺入路。平均手术时间为53±21分钟。4例（1.8%）患者出现早期并发症，对应于0.028并发症/1,000导管天的发生率。一名患者意外动脉穿刺；然而，这不是头静脉切开法的结果，而是锁骨下静脉穿刺的次要结果.无气胸并发症,血胸,或采用头静脉切开法观察动脉穿刺。
结论：这项研究表明，与常规穿刺技术相比，TIVAP的头静脉切开方法具有可接受的成功率和较少的早期并发症。
