Department of Anesthesiology, Shenzhen Children's Hospital, Shenzhen, 518000, Guangdong, China.
World J Surg Oncol. 2022 Aug 30;20(1):272. doi: 10.1186/s12957-022-02734-8.
Accurately positioning totally implantable venous access device (TIVAD) catheters and reducing complications in pediatric patients are important and challenging. A number of studies have shown methods for locating the tip of the TIVAD catheter. We assessed the success and complications of TIVAD implantation guided by transesophageal echocardiography (TEE) via the internal jugular vein (IJV) for 294 patients in this retrospective study.
From May 2019 to March 2021, 297 cases of TIVADs in our hospital were analyzed in this observational, non-randomized, single-center study. The position of the catheter tip under TEE and chest radiography and rates of periprocedural, early, and late complications were evaluated.
The implantation was successful in 242 (82.3%) cases which was in a proper position, and the results were consistent with those of postoperative chest radiography. A total of 72 complications were recorded. Of these, 1 case had a perioperative complication, 66 had early complications, and 5 had late complications after port implantation. The most common complications were local infection and catheter malposition, namely 10 (13.9%) cases of incision infection and 58 (80.6%) cases of catheter malposition. In total, 6 (8.3%) cases of port explantation were required.
Confirmation of proper TIVAD catheter positioning by TEE through an internal jugular approach in children was accurate and safe.
准确定位完全植入式静脉通路装置（TIVAD）导管并减少儿科患者的并发症是重要且具有挑战性的。多项研究已经提出了定位 TIVAD 导管尖端的方法。在这项回顾性研究中，我们通过经食管超声心动图（TEE）经颈内静脉（IJV）引导评估了 294 例患者 TIVAD 植入的成功率和并发症。
在 2019 年 5 月至 2021 年 3 月期间，我们对我院 297 例 TIVAD 进行了观察性、非随机、单中心研究。评估 TEE 和胸部 X 线片下导管尖端的位置以及围手术期、早期和晚期并发症的发生率。
242 例（82.3%）植入成功，位置合适，结果与术后胸部 X 线片一致。共记录 72 例并发症。其中，1 例围手术期并发症，66 例早期并发症，5 例端口植入后晚期并发症。最常见的并发症是局部感染和导管错位，即 10 例（13.9%）切口感染和 58 例（80.6%）导管错位。总共需要 6 例（8.3%）进行端口取出。
通过颈内静脉入路 TEE 确认儿童 TIVAD 导管位置正确且安全。
