Choosing insertion site for totally implantable venous access ports in children
Abstract:
Background and aims: Various venous approaches are possible during implanting a totally venous access port. In this study, we compare the result of venous access port implantation using external and internal jugular vein cut-down in young children to determine the safest method, associated with less complications and higher quality of life.
Patients and methods: January 2018 to January 2022 who received a TIVAP were included in the study and written informed consent was obtained from parents of all children at least 24 h prior to the intervention. One hundred and seven patients who needed TIVAP were randomly allocated into external jugular vein cut-down group (EJVCP) (n = 55) and internal jugular vein cut-down group (IJVCP) (n = 52) in this study.
Results: Mean operative time was 32.5 ± 17.1 min in EJVCP group, and 63.6 ± 28.3 min in IJVCP group. The difference of operation time between the two groups was statistically significant (P < 0.05). The overall incidence of late complications found in this study was 14.5% in EJVCP group and 13.4% in IJVCP group, indicating that no statistical difference was observed.
Conclusions: Compared with internal jugular vein, external jugular vein access has obvious advantages: the location of external jugular vein is superficial and easy to find, the utilization of external jugular vein is easy to learn and master, and the external jugular vein is of little importance to the human body. Through our study, we found that the external jugular vein access does not increase complications. External jugular vein access can be used as the first choice.
Reference:
Zhen C, Yandong W, Mao Y, Chao L, Jun Z. Internal jugular vein versus external jugular vein as the insertion site for totally implantable venous access ports in children: a randomized comparative study. Pediatr Surg Int. 2025 Feb 12;41(1):78. doi: 10.1007/s00383-025-05981-4. PMID: 39937326.