PDF(Pubmed)
Abstract：
BACKGROUND: While vascular puncture is always performed before making port pocket in the implantation of totally implantable venous access ports (TIVAP), some surgeons preferred to make port pocket first. This study seeks to verify the safety and feasibility for the pocket-first technique.
METHODS: The study retrospectively reviewed 447 patients who undergone TIVAP implantation from July 2017 to November 2022. All the patients were divided into two groups based on vascular puncture first or making port pocket first. The general information, operation information and post-operative complications were reviewed and analyzed.
RESULTS: All the operations were performed successfully. No difference was observed in the sex, age, height, weight, BMI, port location and total complication rate between the two groups. The operation time of the Puncture Group and the Pocket Group were 46.9 ± 22.4 min and 33.8 ± 13.6 min ( P<0.00001 ). In the patients of SCV approach, the operation time between the two groups were 37.4 ± 14.8 min and 33.5 ± 10.9 min ( P<0.05 ). Multivariate analysis showed the variable BMI and first procedure were independent prognostic factors for operation time. In the cases using SCV/AxV approach the variable first procedure was the only independent prognostic factor for operation time (P = 0.002).
CONCLUSIONS: The pocket-first technique can be considered as a safe, feasible and convenient technique for TIVAP implantation. The time consuming is significantly shortened compared with the puncture-first technique and this advantage may be more obvious when using SCV/AxV approach.
METHODS: The study retrospectively reviewed 447 patients who undergone TIVAP implantation from July 2017 to November 2022. All the patients were divided into two groups based on vascular puncture first or making port pocket first. The general information, operation information and post-operative complications were reviewed and analyzed.
RESULTS: All the operations were performed successfully. No difference was observed in the sex, age, height, weight, BMI, port location and total complication rate between the two groups. The operation time of the Puncture Group and the Pocket Group were 46.9 ± 22.4 min and 33.8 ± 13.6 min ( P<0.00001 ). In the patients of SCV approach, the operation time between the two groups were 37.4 ± 14.8 min and 33.5 ± 10.9 min ( P<0.05 ). Multivariate analysis showed the variable BMI and first procedure were independent prognostic factors for operation time. In the cases using SCV/AxV approach the variable first procedure was the only independent prognostic factor for operation time (P = 0.002).
CONCLUSIONS: The pocket-first technique can be considered as a safe, feasible and convenient technique for TIVAP implantation. The time consuming is significantly shortened compared with the puncture-first technique and this advantage may be more obvious when using SCV/AxV approach.
摘要：
背景：虽然在植入完全植入式静脉接入端口（TIVAP）时，总是在制作端口袋之前进行血管穿刺，一些外科医生更喜欢先制作端口口袋。本研究旨在验证口袋优先技术的安全性和可行性。
方法：本研究回顾性分析了2017年7月至2022年11月接受TIVAP植入的447例患者。所有患者均按先血管穿刺或先做口袋分为两组。一般资料,回顾并分析手术资料及术后并发症。
结果：所有手术均成功完成。性别没有差异，年龄,高度,体重,BMI,比较两组的端口位置和总并发症发生率。穿刺组和口袋组手术时间分别为46.9±22.4min和33.8±13.6min(P<0.00001)。在SCV入路的患者中，两组手术时间分别为37.4±14.8min和33.5±10.9min(P<0.05)。多因素分析显示，可变的BMI和首次手术是手术时间的独立预后因素。在使用SCV/AxV方法的情况下，可变的首次手术是手术时间的唯一独立预后因素（P=0.002）。
结论：口袋优先技术可以被认为是一种安全的，TIVAP植入的可行和方便的技术。与穿刺优先技术相比，耗时显着缩短，并且在使用SCV/AxV方法时，这种优势可能会更加明显。
方法：本研究回顾性分析了2017年7月至2022年11月接受TIVAP植入的447例患者。所有患者均按先血管穿刺或先做口袋分为两组。一般资料,回顾并分析手术资料及术后并发症。
结果：所有手术均成功完成。性别没有差异，年龄,高度,体重,BMI,比较两组的端口位置和总并发症发生率。穿刺组和口袋组手术时间分别为46.9±22.4min和33.8±13.6min(P<0.00001)。在SCV入路的患者中，两组手术时间分别为37.4±14.8min和33.5±10.9min(P<0.05)。多因素分析显示，可变的BMI和首次手术是手术时间的独立预后因素。在使用SCV/AxV方法的情况下，可变的首次手术是手术时间的唯一独立预后因素（P=0.002）。
结论：口袋优先技术可以被认为是一种安全的，TIVAP植入的可行和方便的技术。与穿刺优先技术相比，耗时显着缩短，并且在使用SCV/AxV方法时，这种优势可能会更加明显。
