External jugular venous cut down technique for placement of chemotherapy port and Hickman catheter: a study of 23 cases

Abstract

Background: Intravenous access devices are an integral part of cancer treatment today as these devices solve the most important problem of venous access for long duration while delivering chemotherapeutic drugs. We used external jugular venous cut down method for insertion of the catheter into central veins in twenty three consecutive patients and studied the outcomes. Methods: We analysed 23 patients who were considered for placement of chemotherapy ports and catheters for various indications. Uniform insertion procedure was followed in all patients. The outcome factors analysed were total operative time, type of anaesthesia, blood loss, and incidence of complications like hematoma and hem pneumothorax, correct placement of the tip, time to start chemotherapy, wound infection. Results: In all the patients, operative time was less than 30 minutes, total blood loss was insignificant which was measured as less than a gauze piece soakage, procedure was comfortably done under local anaesthesia in all the patients, none of the patients had hematoma or chest cavity collections, tip was well placed in superior vena cava except in one where the tip migrated into contralateral brachiocephalic vein, all patients started chemotherapy the next day and there was no wound infection. Conclusion: External jugular venous cut down technique is a very useful easily performed technique with excellent safety profile, very short procedure duration. Hence may be done even by those without a previous exposure to such device placement.