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. 2024 Apr 20;24(1):118.
doi: 10.1186/s12893-024-02404-4.

Application of pocket-first technique for implantation of totally implantable venous access ports

Jingjin Wu  1 , Li Zhang  2 , Xiaojian Jia  1 , Yunchuan Mu  1 , Yanbo Lou  3
Affiliations

Application of pocket-first technique for implantation of totally implantable venous access ports

Jingjin Wu et al. BMC Surg. .

Abstract

Background: While vascular puncture is always performed before making port pocket in the implantation of totally implantable venous access ports (TIVAP), some surgeons preferred to make port pocket first. This study seeks to verify the safety and feasibility for the pocket-first technique.

Methods: The study retrospectively reviewed 447 patients who undergone TIVAP implantation from July 2017 to November 2022. All the patients were divided into two groups based on vascular puncture first or making port pocket first. The general information, operation information and post-operative complications were reviewed and analyzed.

Results: All the operations were performed successfully. No difference was observed in the sex, age, height, weight, BMI, port location and total complication rate between the two groups. The operation time of the Puncture Group and the Pocket Group were 46.9 ± 22.4 min and 33.8 ± 13.6 min ( P<0.00001 ). In the patients of SCV approach, the operation time between the two groups were 37.4 ± 14.8 min and 33.5 ± 10.9 min ( P<0.05 ). Multivariate analysis showed the variable BMI and first procedure were independent prognostic factors for operation time. In the cases using SCV/AxV approach the variable first procedure was the only independent prognostic factor for operation time (P = 0.002).

Conclusions: The pocket-first technique can be considered as a safe, feasible and convenient technique for TIVAP implantation. The time consuming is significantly shortened compared with the puncture-first technique and this advantage may be more obvious when using SCV/AxV approach.

Keywords: Application; Pocket; Surgery; TIVAP.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A) Local anaesthesia for making pocket. (B) Gauze packing hemostasis. (C) Check the integrity of the portal and wash the portal and catheter with heparin saline. (D) Puncture of the axillary vein from the bottom plane of pocket. (E) Introduce the guide wire. (F) The portal is placed into the port pocket after connection of the catheter and portal. (G) Suction test with heparin saline to ensure the patency. (H) Fluoroscopy for confirming a well-adjusted course and radian of the catheter
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