Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2023; 11(1): 116-126
Published online Jan 6, 2023. doi: 10.12998/wjcc.v11.i1.116
Impact of central venous port implantation method and access choice on outcomes
Ayhan Erdemir, Huseyin Kemal Rasa
Ayhan Erdemir, Department of General Surgery, Anadolu Medical Center, Kocaeli 41400, Turkey
Huseyin Kemal Rasa, Department of General Surgery, Anadolu Medical Center Hospital, Kocaeli 41400, Turkey
Author contributions: Erdemir A contributed to the formal analysis of the data, investigation, writing of the original draft, and project administration; Erdemir A and Rasa HK contributed to the conceptualization of the study and methodology; Rasa HK contributed to the review and editing of the manuscript for important intellectual content; and all authors read and approved the final manuscript.
Institutional review board statement: The study was conducted following the Declaration of Helsinki (as revised in 2013) and was approved by the Anadolu Medical Center Hospital review board and ethics committee (ASM-EK-22/187).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets analyzed during the current study are available in the hospital’s “electronic patient records” and from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huseyin Kemal Rasa, MD, Attending Doctor, Department of General Surgery, Anadolu Medical Center Hospital, Cumhuriyet Mahallesi 2255 Sokak No. 3 Gebze, Kocaeli 41400, Turkey. kemrasa@gmail.com
Received: September 23, 2022
Peer-review started: September 23, 2022
First decision: November 11, 2022
Revised: November 24, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 6, 2023
ARTICLE HIGHLIGHTS
Research background

Although the number of patients who need central venous ports for permanent vascular access is increasing, there is still no “gold standard” for implantation technique.

Research motivation

With this retrospective study, we aimed to analyze the outcomes and adverse events in patients with a central venous port to identify the method that should be favored.

Research objectives

The main objective of our study was to compare the two common procedures for central venous port implantation and decide on the best option by analyzing the adverse events and complications.

Research methods

In our study, electronic hospital records of 200 central venous port-implanted patients were retrospectively evaluated. Patients were assigned to two groups according to the access method: The jugular vein and the subclavian vein. Groups were evaluated by age, sex, application side, primary diagnosis, active follow-up period in the hospital, chemotherapy agents administered, number of complications, and the Clavien-Dindo severity score.

Research results

There was no statistically significant difference between groups regarding age, sex, side, number of drugs used for chemotherapy, or duration of port usage (P > 0.05). When the complication rates and the severity of those complications according to the Clavien-Dindo classification were compared, the subclavian vein group was found to have a higher rate of complications, and those complications were also found to be more severe when compared with the jugular vein group (P < 0.05). Parameters like catheter occlusion, infection, and catheter rupture were all higher in the subclavian vein group. We also recorded pneumothorax, mechanical problems like upturned port, and arrhythmia.

Research conclusions

Of 200 consecutive patients who had undergone central venous port implantations through the jugular or subclavian vein were evaluated. There was no statistically significant difference between these two approaches regarding age, sex, side, number of drugs used for chemotherapy, or duration of port usage. The subclavian vein group was found to have a higher rate of complications, and those complications were also found to be more severe when compared with the jugular vein group. Because of these results, we concluded that the jugular vein approach is a feasible and safe option for port implantation and must be preferred to the subclavian vein approach.

Research perspectives

We believe that future studies with many patients and longer follow-ups will validate these results, and the jugular vein approach will be considered the standard technique for central venous port implantation.