Volume 14, Issue 1 ( March 2022 2022)                   Iranian Journal of Blood and Cancer 2022, 14(1): 23-28 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Panahi M, Mohajerzadeh L, Rouzrokh M, Molai Tavana P, Abdollah Gorji F, Ghoroubi J et al . Comparison Between Open and Ultrasonography Guided Venous Access Ports in Children with Malignancy. Iranian Journal of Blood and Cancer 2022; 14 (1) :23-28
URL: http://ijbc.ir/article-1-1082-en.html
Comparison Between Open and Ultrasonography Guided Venous Access Ports in Children with Malignancy
Maryam Panahi1 , Leyli Mohajerzadeh * 2, Mohsen Rouzrokh1 , Parastou Molai Tavana3 , Fatemeh Abdollah Gorji4 , Javad Ghoroubi1 , Ahmad Khalegh Nejad Tabari1
1- Pediatric Surgery Research Center, Pediatric Institute for Children’s Health, Shahid Beheshti University of Medical Sciences,Tehran, Iran
2- Pediatric Surgery Research Center, Pediatric Institute for Children’s Health, Shahid Beheshti University of Medical Sciences,Tehran, Iran , mohajerzadehl@yahoo.com
3- Pediatric Congenital Hematologic Disorder Research Center, Research Institute for Children’s health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4- MSc.Mofid Clinical Research Development Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract:   (1558 Views)

Background: Long-term central venous access is used in children for various reasons specially for delivering chemotherapy. Since vessels in children have smaller diameters, they are more prone to injury and complications such as thrombosis. Different methods are used for implantation of port-a-cath in children. We aimed to compare the complications of insertion of central venous access ports between two methods of open and ultrasound (US) guided. 
Methods: All children who were referred to pediatric surgery department of a children hospital from April 2018 to March 2020 for implantation of port-a-cath were included. Right jugular vein was the target vein and patients were randomly divided between two methods of insertion of open lateral neck exploration and ultrasound real-time guided percutaneous insertion and the reservoir was fixed in subpectoral fascia pouch. All open cases in which jugular vein was ligated proximally were excluded. Patients were followed up for early and late complications two days and one week later by the surgical team, then monthly by a trained nurse and were referred to the surgeon if any complication or malfunction had occurred for at least 6 months.
Results: We included 76 patients (21 girls and 55 boys) less than 18 years of age: 24 patients with ultrasound guided method (1-13 years, median 3 years) and 52 patients with open exploration method (4 months-17 years, median 6 years). We observed no statistically significant difference between two groups with respect to sex, underlying disease, and complications. Most patients had hematological malignancies including ALL (52.9%), AML (19.1%) and the rest had solid organ malignancies. Early complications were observed in 2 (3.8%) in the open and 1 (4.2%) in the US- guided group (P=1). Late complications were observed in 9 (17.3%) patients in the open group and 1 (4.2%) in the US guided group. Infection was observed in 9.6% and malfunction in 5.8% of the open group leading to earlier removal of the catheter. There was not any complication indicative of infection in the US-guided group.
Conclusion: US-guided method can be suggested for routine use as a safe method of insertion of port venous access in children.

Keywords: Children, Central venous access, Port-a-cath, Ultrasound guided, Open method, Malignancy
Full-Text [PDF 468 kb]   (795 Downloads)    
: Original Article | Subject: Cancer Surgery
Received: 2020/11/13 | Accepted: 2022/03/8 | Published: 2022/04/30
References
1. Caers J, Fontaine C, Vinh-Hung V, De Mey J, Ponnet G, Oost C, et al. Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Supportive Care in Cancer. 2005;13(5):325-31. [DOI:10.1007/s00520-004-0723-1]
2. Aribas B, Uylar T, Aksoy M, Turker I, Yildiz F, Tiken R, et al. Factors on patency periods of subcutaneous central venous port: long-term results of 1,408 patients. Cancer Imaging. 2015;15(1):1-. [DOI:10.1186/1470-7330-15-S1-P27]
3. Aribaş BK, Arda K, Aribaş Ö, Çiledağ N, Yoloğlu Z, Aktaş E, et al. Comparison of subcutaneous central venous port via jugular and subclavian access in 347 patients at a single center. Experimental and therapeutic medicine. 2012;4(4):675-80. [DOI:10.3892/etm.2012.649]
4. Plumhans C, Mahnken AH, Ocklenburg C, Keil S, Behrendt FF, Gunther RW, et al. Jugular versus subclavian totally implantable access ports: catheter position, complications and intrainterventional pain perception. Eur J Radiol. 2011;79(3):338-42. [DOI:10.1016/j.ejrad.2009.12.010]
5. Rouzrokh M, Shamsian BS, KhaleghNejad Tabari A, Mahmoodi M, Kouranlo J, Manafzadeh G, et al. Totally implantable subpectoral vs. subcutaneous port systems in children with malignant diseases. Arch Iran Med. 2009;12(4):389-94.
6. Elhady SA, Abd El Hamid EM. Comparative study between open and ultrasound-guided central venous access devices, Al-Azhar Assiut Med. J. 2020;18(1):46-51.
7. Vierboom L, Darani A, Langusch C, Soundappan S, Karpelowsky J. Tunnelled central venous access devices in small children: A comparison of open vs. ultrasound-guided percutaneous insertion in children weighing ten kilograms or less. J Pediatr Surg. 2018;53(9):1832-8. [DOI:10.1016/j.jpedsurg.2018.03.025]
8. Ullman AJ, Marsh N, Mihala G, Cooke M, Rickard CM. Complications of Central Venous Access Devices: A Systematic Review. Pediatrics. 2015;136(5):e1331-44. [DOI:10.1542/peds.2015-1507]
9. Bawazir O, Banoon E. Efficacy and clinical outcome of the port-a-cath in children: a tertiary care-center experience. World J Surg Oncol. 2020;18(1):134. [DOI:10.1186/s12957-020-01912-w]
10. Bawazir OA, Bawazir A. Ultrasound guidance for Port-A-Cath insertion in children; a comparative study. Int J Pediatr Adolesc Med. 2021;8(3):181-5. [DOI:10.1016/j.ijpam.2020.08.002]
11. Laochareonsuk W, Boonsanit K, Chiengkriwate P, Chotsampancharoen T, Sangkhathat S. An appraisal of totally implantable venous access devices in pediatric cancers. Siriraj Medical Journal. 2020;72(2):95-102. [DOI:10.33192/Smj.2020.13]
12. Sofue K, Arai Y, Takeuchi Y, Tsurusaki M, Sakamoto N, Sugimura K. Ultrasonography-guided central venous port placement with subclavian vein access in pediatric oncology patients. J Pediatr Surg. 2015;50(10):1707-10. [DOI:10.1016/j.jpedsurg.2015.05.013]
13. Jahangiri F, Nassiri J, Arjmandi Rafsanjani K, Nahavandi S. Results of Port-a-cath implantation: A single tertiary cancer center experience. Tehran:Iran University of medical science .
14. Tabari AK, Saeeda M, Rouzrokh M, Mirshemirani A. Applying totally implantable venous access devices (TIVAD) in children: The first iranian experience. Iran J Blood Cancer. 2010;2(3):127-30.
15. Paterson RS, Chopra V, Brown E, Kleidon TM, Cooke M, Rickard CM, et al. Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review. Pediatrics. 2020;145(Suppl 3):S243-S68. [DOI:10.1542/peds.2019-3474H]
16. Martynov I, Klima-Frysch J, Kluwe W, Engel C, Schoenberger J. Safety of tunneled central venous catheters in pediatric hematopoietic stem cell recipients with severe primary immunodeficiency diseases. PLoS One. 2020;15(5):e0233016. [DOI:10.1371/journal.pone.0233016]
17. van den Bosch CH, van der Bruggen JT, Frakking FNJ, Terwisscha van Scheltinga CEJ, van de Ven CP, van Grotel M, et al. Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study. J Pediatr Surg. 2019;54(9):1894-900. [DOI:10.1016/j.jpedsurg.2018.10.054]
18. Karakitsos D, Labropoulos N, De Groot E, Patrianakos AP, Kouraklis G, Poularas J, et al. Realtime ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care. 2006;10(6):R162. [DOI:10.1186/cc5101]
19. Lau CS, Chamberlain RS. Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis. Pediatr Res. 2016;80(2):178-84. [DOI:10.1038/pr.2016.74]
20. Calvo JP, Valls JC, Crusellas O, Petrone P. Comparative Study of Access Routes for Port-ACath® Implantation. Cirugía Española (English Edition). 2020;98(2):79-84. [DOI:10.1016/j.cireng.2020.01.013]
21. de Souza TH, Brandao MB, Nadal JAH, Nogueira RJN. Ultrasound Guidance for Pediatric Central Venous Catheterization: A Meta-analysis. Pediatrics. 2018;142(5). [DOI:10.1542/peds.2018-1719]
22. Hancock-Howard R, Connolly BL, McMahon M, Menon A, Woo G, Wales PW, et al. Cost-effectiveness analysis of implantable venous access device insertion using interventional radiologic versus conventional operating room methods in pediatric patients with cancer. 2010;21(5):677-84. [DOI:10.1016/j.jvir.2010.01.014]
23. Choi JS, Park KM, Jung S, Hong KC, Jeon YS, Cho SG, et al. Usefulness of Percutaneous Puncture in Insertion of Totally Implantable Venous Access Devices in Pediatric Patients. Vasc Specialist Int. 2017;33(3):108-11. [DOI:10.5758/vsi.2017.33.3.108]
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 All Rights Reserved | Iranian Journal of Blood and Cancer

Designed & Developed by : Yektaweb