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经右颈内静脉双超声引导下为癌症患儿植入全植入式静脉通路端口:单机构初步经验

Dual ultrasound-guided totally implantable venous access ports via the right internal jugular vein in pediatric patients with cancer: a preliminary experience in a single institution.

作者信息

Deng Xiao Bin, Peng Liang, Zhang Jun, Kong Xiangru, Zhao Zhenzhen, Wang Shan, Li Changchun, Du Yifei, Zhou Jianwu, Liu Lifei, Yang Chao

机构信息

Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics,Chongqing Medical University Affiliated Children's Hospital, Chongqing, China.

Department of Pediatric Anesthesia, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongging Key Laboratory of Pediatrics,Chongqing Medical University Affiliated Children's Hospital, Chongqing, China.

出版信息

World J Pediatr Surg. 2023 Jun 29;6(3):e000509. doi: 10.1136/wjps-2022-000509. eCollection 2023.

Abstract

OBJECTIVE

To assess the efficacy and safety of dual ultrasound-guided (DUG) totally implantable venous access port (TIVAP) implantation (namely, using ultrasound-guided percutaneous puncture with transesophageal echocardiography-guided catheterization) via the right internal jugular vein (IJV) in pediatric patients with cancer.

METHODS

Fifty-five children with cancer requiring chemotherapy underwent DUG-TIVAP implantation via the right IJV. Clinical data were recorded, including the procedure success rate, first attempt success rate, and perioperative and postoperative complications.

RESULTS

All 55 cases were successfully operated on. The first puncture success rate was 100%. The operation time was 22-41 min, with a mean time of 30.8±5.5 min. The mean TIVAP implantation time was 253±145 days (range 42-520 days). There were no perioperative complications. The postoperative complication rate was 5.4% (3/55), including skin infections around the port in one case, catheter-related infection in one case, and fibrin sheath formation in one case. The ports were all preserved after anti-infection or thrombolytic therapy. No unplanned port withdrawal was recorded in this study.

CONCLUSIONS

DUG-TIVAP implantation is a technique with a high success rate and a low complication rate; therefore, it provides an alternative for children with cancer. Further randomized controlled studies are needed to confirm the efficacy and safety of DUG-TIVAP via the right IJV in children.

摘要

目的

评估双超声引导(DUG)下经右颈内静脉(IJV)为癌症患儿植入全植入式静脉通路端口(TIVAP)(即超声引导下经皮穿刺并经食管超声心动图引导置管)的有效性和安全性。

方法

55例需要化疗的癌症患儿接受了经右颈内静脉的双超声引导下TIVAP植入术。记录临床数据,包括手术成功率、首次尝试成功率以及围手术期和术后并发症。

结果

55例手术均成功。首次穿刺成功率为100%。手术时间为22 - 41分钟,平均时间为30.8±5.5分钟。TIVAP平均植入时间为253±145天(范围42 - 520天)。围手术期无并发症。术后并发症发生率为5.4%(3/55),包括1例端口周围皮肤感染、1例导管相关感染和1例纤维蛋白鞘形成。经抗感染或溶栓治疗后,端口均得以保留。本研究中未记录到计划外的端口拔除情况。

结论

双超声引导下TIVAP植入术是一种成功率高、并发症发生率低的技术;因此,它为癌症患儿提供了一种选择。需要进一步的随机对照研究来证实经右颈内静脉双超声引导下TIVAP在儿童中的有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc2/10314620/90b24a0821f5/wjps-2022-000509f01.jpg

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