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Confounding in statistical epidemiology represents a pivotal challenge, referring to the distortion in the perceived relationship between an exposure and an outcome due to the presence of a third variable, known as a confounder. This variable is associated with both the exposure and the outcome but is not a direct link in their causal chain. Its presence can lead to erroneous interpretations of the exposure's effect, either exaggerating or underestimating the true association. This...
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Related Experiment Video

Updated: Oct 22, 2025

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
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Why do subcutaneous ports get stuck? A case-control study.

Jennifer L Crook1, Zhaohua Lu2, Xiaoqing Wang2

  • 1Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place Mail Stop 133, Memphis, TN 38105, USA; College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38105, USA.

Journal of Pediatric Surgery
|August 30, 2021
PubMed
Summary
This summary is machine-generated.

Difficult removal of subcutaneous ports in children is linked to a diagnosis of acute lymphoblastic leukemia (ALL) and longer placement duration. Polyurethane catheters and subclavian access also increase the risk of stuck ports.

Keywords:
Acute lymphoblastic leukemiaStuck catheterSubcutaneous port

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Area of Science:

  • Pediatric Surgery
  • Oncology
  • Medical Devices

Background:

  • Subcutaneous ports are essential for long-term venous access in pediatric patients, particularly those undergoing chemotherapy.
  • Complications, such as difficult port removal, can prolong procedures and increase morbidity.

Purpose of the Study:

  • To identify clinical features associated with difficult (stuck) subcutaneous port removals in children.
  • To inform strategies for managing and preventing port removal complications.

Main Methods:

  • A prospective case-control study was conducted, comparing children with stuck ports to age- and sex-matched controls.
  • Logistic regression and multivariable analysis were used to identify independent predictors of difficult port removal.

Main Results:

  • Stuck ports were significantly associated with a diagnosis of acute lymphoblastic leukemia (ALL) and longer duration of port placement.
  • Factors such as subclavian vein access, polyurethane catheter material, and rough catheter appearance at removal were linked to difficult removals.
  • A diagnosis of ALL and prolonged line placement duration were independent predictors of stuck ports.

Conclusions:

  • Polyurethane central venous catheters used for the treatment of ALL may be prone to difficult removal.
  • These findings suggest a need for enhanced preoperative risk assessment, consideration of endovascular backup, and optimized operating room scheduling for these patients.