手术住院医师术前超声引导下经皮头皮静脉切开术建立完全植入式中心静脉通路装置。
Cephalic Vein Cut-down for Totally Implantable Central Venous Access Devices With Preoperative Ultrasonography by Surgical Residents.
机构信息
Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
出版信息
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.
PATIENTS AND METHODS
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.
RESULTS
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.
CONCLUSION
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。
患者和方法
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。
结果
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。
结论
在术前 US 引导下，外科住院医师可以安全地进行 CV 切开术。
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