Forty years after the first totally implantable venous access device (TIVAD) implant: the pure surgical cut-down technique only avoids immediate complications that can be fatal.

Percutaneous approach Pneumothorax Port-a-cath Surgical cut-down Totally implantable venous access device (TIVAD)

Journal

Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 18 05 2021
accepted: 01 06 2021
pubmed: 11 6 2021
medline: 2 10 2021
entrez: 10 6 2021
Statut: ppublish

Résumé

Even though TIVADs have been implanted for a long time, immediate complications are still occurring. The aim of this work was to review different techniques of placing TIVAD implants to evaluate the aetiology of immediate complications. A systematic literature review was performed using the PubMed, Cochrane and Google Scholar databases in accordance with the PRISMA guidelines. The patient numbers, number of implanted devices, specialists involved, implant techniques, implant sites and immediate complication onsets were studied. Of the 1256 manuscripts reviewed, 36 were eligible for inclusion in the study, for a total of 17,388 patients with equivalent TIVAD implantation. A total of 2745 patients (15.8%) were treated with a surgical technique and 14,643 patients (84.2%) were treated with a percutaneous technique. Of the 2745 devices (15.8%) implanted by a surgical technique, 1721 devices (62.7%) were placed in the cephalic vein (CFV). Of the 14,643 implants (84.2%) placed with a percutaneous technique, 5784 devices (39.5%) were placed in the internal jugular vein (IJV), and 5321 devices (36.3%) were placed in the subclavian vein (SCV). The number of immediate complications in patients undergoing surgical techniques was 32 (1.2%) HMMs. In patients treated with a percutaneous technique, the number of total complications were 333 (2.8%): 71 PNX (0.5%), 2 HMT (0.01%), 175 accidental artery punctures AAP (1.2%) and 85 HMM (0.6%). No mortality was reported with either technique. The percutaneous approach is currently the most commonly used technique to implant a TIVAD, but despite specialist's best efforts, immediate complications are still occurring. Surgical cut-down, 40 years after the first implant, is still the only technique that can avoid all of the immediate complications that can be fatal.

Identifiants

pubmed: 34109472
doi: 10.1007/s00423-021-02225-6
pii: 10.1007/s00423-021-02225-6
pmc: PMC8481188
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1739-1749

Informations de copyright

© 2021. The Author(s).

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Auteurs

Adriana Toro (A)

General Surgery, Augusta Hospital, Syracuse, Italy.

Elena Schembari (E)

Department of General Surgery, Whipps Cross University Hospital-Barts Health NHS Trust, Whipps Cross Rd, Leytonstone, , London, E11 1NR, UK.

Emanuele Gaspare Fontana (EG)

Department of Surgical Sciences and Advanced Technologies "G.F. Ingrassia," Cannizzaro Hospital, General Surgery, University of Catania, Via Messina 829, 95126, Catania, Italy.

Salomone Di Saverio (S)

Department of General Surgery, University Hospital of Varese, University of Insubria, Varese, Italy.
Cambridge Colorectal Unit, Addenbrooke's University Hospital NHS Foundation Trust, Cambridge, UK.

Isidoro Di Carlo (I)

Department of Surgical Sciences and Advanced Technologies "G.F. Ingrassia," Cannizzaro Hospital, General Surgery, University of Catania, Via Messina 829, 95126, Catania, Italy. idicarlo@unict.it.

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