Comparison of Outcomes and Complications of Implantation of Port Catheters via Subclavian Vein or External Jugular Vein Cut-Down in Children

Abstract

Background: Port catheter is a new generation of central venous catheter used in patients with cancer to prescribe chemotherapy drugs. There are various methods for inserting this catheter, and the aim of present study was to evaluate the complications of catheter insertion via subclavian or external jugular vein cut-down. Methods: The study was performed on 80 patients with malignancy requiring port catheter insertion. External jugular vein cut-down and Seldinger method via subclavian vein was used for vein access in groups A and B, respectively. To implant the port chamber, a cavity was created in the subcutaneous tissue below the clavicle. Then, a tunnel was made between the cavities and puncture site for the bypass catheter, and the catheter tip was attached to the port compartment. All patients were evaluated for intraoperative complications such as pneumothorax, hemorrhage, artery rupture, inappropriate port catheter place, and embolism, as well as late complications such as infection, thrombosis, extravasation, catheter rupture, and pulmonary embolism. Findings: Early complications such as pneumothorax (12.5% vs. 0.0%) and hematoma (15.0% vs. 2.5%) were more common in group B (P < 0.050). Moreover, delayed complications such as infection (9 vs. 2 cases), venous thrombosis (7 vs. 1 patients), catheter obstruction (8 vs. 2 cases), and cellulitis (8 vs. 2 patients) were more common in group B, too (P < 0.050). Conclusion: Despite higher insertion time, port catheter insertion via subclavian vein was a better method than external jugular vein due to lower incidence of early and late complications.

Keywords

• jugular veins
• subclavian vein
• port catheters