Unknown

Dataset Information

0

Meta-analysis of primary open versus closed cannulation strategy for totally implantable venous access port implantation.


ABSTRACT:

Background

There is still no reference standard for the implantation of totally implantable venous access ports (TIVAPs). A recently published multicentre randomised controlled trial (RCT) revealed a significantly greater risk of pneumothorax after closed cannulation than after an open strategy. The aim of this meta-analysis was to provide an update of the available evidence for the safety and effectiveness of primary open versus closed cannulation strategy.

Methods

RCTs comparing outcomes of open cut-down of the cephalic vein and closed cannulation of the subclavian vein were sought systematically in MEDLINE, Web of Science and CENTRAL. The primary outcome was the occurrence of pneumothorax. A beta-binominal model was applied to combine the respective outcomes, and results are presented as odds ratios (OR) with 95% confidence interval (CI).

Results

Six RCTs with a total of 1831 patients were included in final analysis. Meta-analysis showed statistically significant superiority of the open cut-down technique regarding pneumothorax (OR 0.308, 95% CI 0.122 to 0.776), but a statistically significant higher failure of the primary technique for the open cut-down technique than for closed cannulation (OR 2.364, 95% CI 1.051 to 5.315). There were no significant differences between the two procedures regarding other morbidity endpoints.

Conclusion

This meta-analysis shows a general superiority of open cut-down of the cephalic vein over closed cannulation of the subclavian vein regarding the occurrence of pneumothorax. Open cut-down should be the first-line approach for TIVAP implantation. Closed cannulation should be performed with ultrasound as second-line procedure if the open technique fails.

Systematic review registration

PROSPERO CRD42013005180.

SUBMITTER: Klaiber U 

PROVIDER: S-EPMC8106576 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

altmetric image

Publications

Meta-analysis of primary open versus closed cannulation strategy for totally implantable venous access port implantation.

Klaiber Ulla U   Probst Pascal P   Hackbusch Matthes M   Jensen Katrin K   Dörr-Harim Colette C   Hüttner Felix J FJ   Hackert Thilo T   Diener Markus K MK   Büchler Markus W MW   Knebel Phillip P  

Langenbeck's archives of surgery 20210109 3


<h4>Background</h4>There is still no reference standard for the implantation of totally implantable venous access ports (TIVAPs). A recently published multicentre randomised controlled trial (RCT) revealed a significantly greater risk of pneumothorax after closed cannulation than after an open strategy. The aim of this meta-analysis was to provide an update of the available evidence for the safety and effectiveness of primary open versus closed cannulation strategy.<h4>Methods</h4>RCTs comparing  ...[more]

Similar Datasets

| S-EPMC4410572 | biostudies-other
| S-EPMC7803355 | biostudies-literature
| S-EPMC4396913 | biostudies-other
| S-EPMC4141057 | biostudies-other
| S-EPMC4422989 | biostudies-other
| S-EPMC8689318 | biostudies-literature
| S-EPMC6464051 | biostudies-literature
| S-EPMC120668 | biostudies-literature
| S-EPMC8632700 | biostudies-literature