Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
In Vivo. 2019 Nov-Dec;33(6):2079-2085. doi: 10.21873/invivo.11707.
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.
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.
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.
CV cut-down can be safely performed by surgical residents under the use of preoperative US.
背景/目的：由于头静脉（CV）切开术的成功率较低，因此很少用于完全植入式中心静脉通路装置（TICVAD）。我们比较了由经验丰富的外科医生和外科住院医师术前超声（US）引导下进行 CV 切开术的结果。
2015 年 12 月至 2017 年 12 月，10 名外科医生使用术前 US 引导下的 CV 切开术植入了 212 个 TICVAD。外科医生分为两组，每组 5 名：外科住院医师（A 组，n=124 例）和经验丰富的外科医生（B 组，n=88 例）。回顾性分析手术时间、完成率和并发症。
A 组的完成率明显更高（98.4%比 92.0%，p=0.04）。手术时间（45.2±14.5 比 42.0±13.1 分钟，p=0.22）、早期并发症发生率（1.6%比 1.1%，p=0.77）和晚期并发症发生率（3.2%比 2.3%，p=0.68）在两组之间无差异。两组均无致命性并发症发生。
在术前 US 引导下，外科住院医师可以安全地进行 CV 切开术。
