ORIGINAL REPORTSThe Safety Level of Total Central Venous Access Port Implantation Performed by Residents
Section snippets
INTRODUCTION
Because of the provision of substantial resources, operation time in university hospitals is much more expensive per minute compared with a regional or community hospital. Therefore, basic surgical procedures often create a controversial situation, given their importance for additional surgical education, as university hospitals educate a significant number of residents. Totally implantable venous access ports (TIVAPs) represent one of these procedures, although it is necessary to be taught.1, 2
METHODS
All TIVAP implantations were performed between March 2008 and December 2016 in the Department of General and Visceral Surgery of the University Hospital Frankfurt, and were included in a retrospective database.
RESULTS
Between March 2008 and December 2016, there were 799 TIVAP implantations in our clinic. After exclusion of reimplantations, 760 cases were analyzed (Figure).
DISCUSSION
This retrospective analysis shows postoperative results after TIVAP implantations performed by residents in comparison to attending surgeons. It revealed that TIVAP implantations can be safely done by residents. Nevertheless, there are differences between attending surgeons and residents performing TIVAP implantations. Attending surgeons and consultants demonstrated a significantly shorter operative time and a lower rate of SSI. But no significant differences were found for major complications,
CONCLUSION
TIVAP implantation is a surgical procedure requiring basic skills: It has a low overall complication rate; although major, life-threatening complications can occur. This study reveals that TIVAP implantations by surgical residents are safe and can be used as a training procedure without putting patients at risk of severe complications.
ACKNOWLEDGMENTS
The authors would like to thank Mr. Ulrich Forster from the Communication, Information and Media Center of the University of Hohenheim, for reviewing the statistical analyses and helping with further improvements.
AUTHOR CONTRIBUTIONS
All authors made substantial contributions to the design and analysis of this work, which included drafting and assessing the manuscript. All authors approved the final manuscript for submission and agreed to be accountable for the work.
REFERENCES (19)
- et al.
Proctologic surgery done by residents – complications preprogrammed
J Visc Surg
(2016) - et al.
Do attending surgeons and residents see eye to eye? An evaluation of the accreditation council for graduate medical education milestones in general surgery residency
J Surg Educ
(2016) - et al.
Analysis of the outcomes in central venous access port implantation performed by residents via the internal jugular vein and subclavian vein
J Surg Educ
(2017) - et al.
Complication-related removal of totally implantable venous access port systems: does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients
Eur J Surg Oncol
(2017) - et al.
Catheter fracture and embolization associated with arm implantation of the cook vital port
Can Assoc Radiol J
(2013) - et al.
The influence of diabetes mellitus on postoperative infections
Crit Care Nurs Clin North Am
(2003) - et al.
Education in thyroid surgery: a matched-pair analysis comparing residents and board-certified surgeons
Langenbecks Arch Surg
(2016) - et al.
Central venous access port-related complications in outpatient chemotherapy for colorectal cancer
Jpn J Clin Oncol
(2007) - et al.
Characterization of refractory port-related blood stream infections in intestinal failure patients on parenteral nutrition
Z Gastroenterol
(2011)
Cited by (13)
Vascular access device type for systemic anti-cancer therapies in cancer patients: A scoping review
2024, Critical Reviews in Oncology/HematologyEfficacy, Safety, and Cost-Effectiveness of Intracavitary Electrocardiography-Guided Catheter Tip Placement for Totally Implantable Venous Access Port
2022, Annals of Vascular SurgeryCitation Excerpt :In addition, obesity was also associated with extravasation24 and catheter-related infection.25-26 However, some studies showed that there was no significant relationship between complications and BMI27, and even lower BMI was related to postoperative complications.28 These contradictory results may be related to the differences in population characteristics and surgical procedures.
Risk factors of implantable venous access port-related bloodstream infections in cancer patients:a Meta-analysis
2023, Chinese Journal of Practical Nursing
Funding: None.