ID 5516
File
Authors
Takano, Shuichi Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Tottori University Researchers
Shimizu, Norio Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine,
Tokuyasu, Naruo Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Tottori University Researchers
Sakamoto, Teruhisa Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Tottori University Researchers
Honjo, Soichiro Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Tottori University Researchers
Ashida, Keigo Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Tottori University Researchers KAKEN Search Researchers
Saito, Hiroaki Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Tottori University Researchers KAKEN Search Researchers
Fujiwara, Yoshiyuki Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Tottori University Researchers KAKEN Search Researchers
Keywords
central venous catheter
children
pediatric intervention
real-time ultrasound guide
venography guide
NDC
Natural science
Abstract
[Background]Tunneled central venous catheters (CVC), called Broviac/Hickman catheter, are widely used in the long-term treatment of pediatric patients. Recently, the percutaneous approach for CVC insertion has become dominant as a less invasive intervention. In this study, we reviewed the mechanical and delayed complications according to different procedures of CVC insertion and assessed the risk factors for complications in CVC insertions for pediatric patients.
[Methods]A total of 159 pediatric patients (85 males and 74 females) were included in this study. Primary reasons for indication of CVC settlement were hemato-oncologic disorders (66 cases, 42%), malignant solid tumors (30, 19%) and other benign diseases (63, 40%). CVC insertion was performed with surgical venous cutdown (CD) in 51 patients (32%), with real-time ultrasound-guided puncture (RTUS) in 57 (36%), and venography-guided puncture (VG) in 49 (31%).
[Results]CD was dominantly selected and the frequency of venipuncture increased respective to the increased age of patients. RTUS was dominantly selected for one to four year old patients and VG was dominant in 5 to 15 year old patients. Some types of mechanical complication were observed in 4 of 159 (2.5%) and some delayed types were observed in 66 of 159 cases (42%). No mechanical complications occurred in cases with CD and RTUS; on the other hand, 3 (6%) of 49 insertions with VG were observed. However, we could not show any significant risk factors for the mechanical complications. In the meantime, delayed complications and premature removal were significantly observed in patients under 5 years old.
[Conclusion]RTUS is superior to our conventional VG considering less frequent mechanical complications. High frequent delayed complication and premature removal should be considered, especially for patients under 5 years old.
Publisher
Tottori University Faculty of Medicine
Content Type
Journal Article
ISSN・ISBN
1346-8049
NCID
AA00892882
Journal Title
Yonago Acta Medica
Current Journal Title
Yonago Acta Medica
Volume
60
Issue
4
Start Page
234
End Page
240
Published Date
2018-02-05
Text Version
Publisher
Citation
Yonago Acta Medica. 2017, 60(4), 234-240
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English