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Published on: March 31, 2023
Internal jugular vein versus external jugular vein as the insertion site for totally implantable venous access ports
Chen Zhen1, Wei Yandong1, Ye Mao1
1Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
Insights
For pediatric venous access ports, external jugular vein cut-down is a safe and effective method. This technique offers advantages over internal jugular vein access, with comparable complication rates.
Area of Science:
- Pediatric Surgery
- Vascular Access
- Oncology Support
Background:
- Totally venous access ports (TIVAP) are crucial for long-term therapies in children.
- Various surgical approaches exist for TIVAP implantation, each with potential risks and benefits.
Purpose of the Study:
- To compare the safety and efficacy of external jugular vein cut-down versus internal jugular vein cut-down for TIVAP implantation in young children.
- To evaluate complication rates and quality of life associated with each surgical approach.
Main Methods:
- A randomized study included 107 children requiring TIVAP implantation between January 2018 and January 2022.
- Patients were randomly assigned to either the external jugular vein cut-down group (EJVCP) or the internal jugular vein cut-down group (IJVCP).
Main Results:
- Mean operative time was significantly shorter in the EJVCP group (32.5 min) compared to the IJVCP group (63.6 min).
- The overall incidence of late complications was similar between the EJVCP group (14.5%) and the IJVCP group (13.4%).
Conclusions:
- External jugular vein access is superficial, easy to learn, and poses minimal physiological importance.
- External jugular vein cut-down is a safe and effective first-choice method for TIVAP implantation in children, without increasing complications.
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.
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