Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Pediatr Surg Int. 2022 Dec;38(12):1855-1860. doi: 10.1007/s00383-022-05233-9. Epub 2022 Sep 22.
The number of accessible central veins (CVs) affects the prognosis of patients with intestinal failure (IF). The loss of residual CVs should be avoided. We, therefore, evaluated the efficacy of a new CV catheter-exchange technique using a subcutaneous fibrous sheath (FS) in pediatric IF patients.
We retrospectively collected the CV catheter (CVC) data of pediatric IF patients managed from January 2009 to December 2019. The data were divided into two groups; Groups 1 (CVCs placed with the FS method) and Group 2 (CVCs placed by the primary or another insertion). The main outcome was the CVC indwelling time.
Eighty-five CVCs were analyzed. The FS method was attempted in 47 cases and succeeded in 40 (85%). No significant difference was observed between the groups regarding characteristics. A log-rank test revealed an equivalent CVC indwelling time between the two groups (Group 1: 268 [126-588] days vs. Group 2: 229 [126-387] days, p = 0.256).
The FS method is highly recommended for pediatric IF patients, as its attempt showed a high success rate with an indwelling time equivalent to primary insertion. The FS method leads to the prolonged use of a single CV and thereby contributes to improving the outcomes of pediatric IF patients.
可触及中心静脉（CV）的数量影响肠衰竭（IF）患者的预后。应避免残留 CV 的丢失。因此，我们评估了一种新的 CV 导管交换技术在儿科 IF 患者中的疗效，该技术使用皮下纤维鞘（FS）。
我们回顾性收集了 2009 年 1 月至 2019 年 12 月期间接受管理的儿科 IF 患者的 CV 导管（CVC）数据。这些数据分为两组；组 1（使用 FS 方法放置的 CVC）和组 2（使用初次或另一次插入放置的 CVC）。主要结局是 CVC 留置时间。
分析了 85 根 CVC。在 47 例患者中尝试了 FS 方法，其中 40 例（85%）成功。两组患者的特征无显著差异。对数秩检验显示两组之间的 CVC 留置时间相当（组 1：268[126-588]天 vs. 组 2：229[126-387]天，p=0.256）。
强烈建议儿科 IF 患者使用 FS 方法，因为尝试该方法的成功率很高，留置时间与初次插入相当。FS 方法可延长单个 CV 的使用时间，从而有助于改善儿科 IF 患者的结局。
