Pediatric Surgery Department, Federal University of São Paulo, São Paulo, Brazil.
Pediatr Blood Cancer. 2012 Feb;58(2):274-7. doi: 10.1002/pbc.23220. Epub 2011 Jun 14.
This prospective randomized study evaluated complications related to long-term totally implantable catheters in oncologic children and adolescents by comparing venopunction performed either in the jugular or subclavian vein.
A total of 83 catheters were implanted from January 2004 to April 2006 and followed-up until March 2008. Patients were randomly allocated to the subclavian or jugular vein group. The endpoint was complications that led to catheter revision or catheter removal.
Six patients were excluded, 43 had the catheter implanted in the subclavian and 34 in the jugular vein. Subclavian catheters were used for up to 12.6 months, while jugular catheters were kept in place for up to 14.8 months (P = 0.38). No statistical differences were found between the groups concerning age, sex, leukocyte count, platelet count, type of admission (in or outpatient), or previous chemotherapy regimens. When analyzed individually, long-term complications did not present statistically significant differences either. Infection occurred in 20 and 11% (P = 0.44), while catheter embolism took place in 23 and 8% (P = 0.11) of patients with subclavian and jugular catheters, respectively. A statistical difference was seen in the total number of complications, which occurred in 48 and 23% (P = 0.02) of patients in the subclavian and in the jugular groups, respectively.
Catheters implanted by puncture in the subclavian vein were more prone to late complications than those implanted in the jugular vein.
本前瞻性随机研究通过比较经颈内静脉和锁骨下静脉行静脉穿刺置管术，评估了长期全植入式导管在肿瘤患儿和青少年中的并发症，并将结果进行了对比。
2004 年 1 月至 2006 年 4 月共植入 83 根导管，随访至 2008 年 3 月。患者被随机分配到锁骨下静脉组或颈内静脉组。终点是导致导管修改或导管移除的并发症。
6 名患者被排除在外，43 名患者在锁骨下静脉植入导管，34 名患者在颈内静脉植入导管。锁骨下导管最长使用时间为 12.6 个月，而颈内导管最长使用时间为 14.8 个月（P = 0.38）。两组在年龄、性别、白细胞计数、血小板计数、入院类型（门诊或住院）或之前的化疗方案方面无统计学差异。单独分析时，长期并发症也没有统计学差异。感染发生率分别为 20%和 11%（P = 0.44），而导管栓塞发生率分别为 23%和 8%（P = 0.11）。锁骨下组和颈内组的总并发症发生率分别为 48%和 23%，差异有统计学意义（P = 0.02）。
经锁骨下穿刺植入的导管比经颈内静脉植入的导管更容易发生晚期并发症。
