Guangdong Provincial Key Laboratory of Malignant Tumor, Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
BMC Cancer. 2022 Mar 5;22(1):248. doi: 10.1186/s12885-022-09228-6.
Axillary vein/subclavian vein (AxV/SCV) and Internal jugular vein (IJV) are commonly used for implantable venous access port (IVAP) implantation in breast cancer patients for chemotherapy. Previous research focused on comparison of complications while patient comfort was ignored. This study aims to compare patient comfort, surgery duration and complications of IVAP implantation between IJV and AxV/SCV approaches.
Two hundred forty-eight breast cancer patients were enrolled in this randomized controlled study from August 2020 to June 2021. Patients scheduled to undergo IVAP implantation were randomly and equally assigned to receive central venous catheters with either AxV /SCV or IJV approaches. All patients received comfort assessment using a comfort scale table at day 1, day 2 and day 7 after implantation. Patient comfort, procedure time of operation as well as early complications were compared.
Patient comfort was significantly better in the AxV/SCV group than that of IJV group in day 1 (P < 0.001), day 2 (P < 0.001) and day 7(P = 0.023). Procedure duration in AxV/SCV group was slightly but significantly shorter than IJV group (27.14 ± 3.29 mins vs 28.92 ± 2.54 mins, P < 0.001). More early complications occurred in AxV/SCV group than IJV group (11/124 vs 2/124, P = 0.019). No difference of complications of artery puncture, pneumothorax or subcutaneous hematoma between these two groups but significantly more catheter misplacement in AxV/SCV group than IJV group (6/124 vs 0/124, P = 0.029). Absolutely total risk of complications was rather low in both groups (8.87% in AxV/SCV group and 1.61% in IJV group).
Our study indicates that patients with AxV/SCV puncture have higher comfort levels than IJV puncture. AxV/SCV puncture has shorter procedure duration but higher risk of early complications, especially catheter misplacement. Both these two approaches have rather low risk of complications. Consequently, our study provides an alternative choice for breast cancer patients to reach better comfort.
腋窝静脉/锁骨下静脉（AxV/SCV）和颈内静脉（IJV）常用于乳腺癌患者化疗的植入式静脉输液港（IVAP）植入。既往研究主要关注并发症的比较，而忽略了患者舒适度。本研究旨在比较 IJV 和 AxV/SCV 入路在 IVAP 植入术中患者舒适度、手术时间和并发症方面的差异。
2020 年 8 月至 2021 年 6 月，我们将 248 例乳腺癌患者纳入这项随机对照研究。计划行 IVAP 植入的患者随机等分为 AxV/SCV 或 IJV 组。所有患者在植入后第 1、2 和 7 天使用舒适度量表进行舒适度评估。比较两组患者的舒适度、手术时间和早期并发症。
AxV/SCV 组患者在植入后第 1、2 和 7 天的舒适度均显著优于 IJV 组（P<0.001）。AxV/SCV 组的手术时间略短于 IJV 组（27.14±3.29 分钟 vs 28.92±2.54 分钟，P<0.001）。AxV/SCV 组的早期并发症发生率高于 IJV 组（11/124 比 2/124，P=0.019）。两组患者动脉穿刺、气胸或皮下血肿并发症发生率无差异，但 AxV/SCV 组导管异位的发生率显著高于 IJV 组（6/124 比 0/124，P=0.029）。两组的并发症总风险均较低（AxV/SCV 组 8.87%，IJV 组 1.61%）。
本研究表明，AxV/SCV 穿刺患者的舒适度高于 IJV 穿刺患者。AxV/SCV 穿刺手术时间较短，但早期并发症风险较高，尤其是导管异位风险较高。两种方法的并发症风险均较低。因此，本研究为乳腺癌患者提供了一种可选择的以达到更好舒适度的方法。
