Portocath insertion technique: retrospective study & step-by-step surgical description without tunneling in a high-complexity service

ABSTRACT Objective: to demonstrate that the use of the portocath implantation technique without tunneling the catheter is not associated with a higher rate of complications in the short or long term. In addition, we aim to improve the implantation technique of the portocath device, with the presentation of a step-by-step guide for surgeons in training. Methods: this is a retrospective descriptive study, with analytical components. Data were analyzed using information extracted from electronic medical records linked to the National Health Care procedure code between the years 2019-2020. Results: none of the 94 procedures resulted in complications on the day they were performed. Complications were recorded seven days after the procedure in only two patients (2.13%). Intraoperative radioscopy had been performed in both cases. Thirty days afters the procedure, complications were observed in two patients among the remaining 92 (2.17%), both undergoing catheter implantation without tunneling. There were no complications in the six months after portocath implantation in 57.4% of patients and there is no information about the other 42.6%. Conclusion: the portocath insertion technique without tunneling is a safe outpatient procedure, with a low risk of complications, and can be adopted to shorten procedure time and patient discomfort, without functional or safety impairments. There was no association of not tunneling the catheter, laterality of the punctured vein and performing radioscopy in the transoperative period with the rate of complications.

摘要
目的：论证采用非隧道化导管的植入式静脉输液港（portocath）植入技术，并不会在短期或长期层面带来更高的并发症发生率。此外，本研究旨在优化植入式静脉输液港装置的植入操作技术，为受训外科医师提供分步操作指南。
方法：本研究为兼具分析性的回顾性描述性研究，分析数据提取自2019至2020年间关联国家医疗服务程序编码的电子病历。
结果：94例手术当日均未出现并发症。术后7天仅2例患者（2.13%）记录出现并发症，该2例均实施了术中透视检查。术后30天，剩余92例患者中仅2例出现并发症（2.17%），且该2例均采用了非隧道化导管的植入方式。57.4%的患者在植入式静脉输液港植入后6个月内未出现并发症，其余42.6%的患者无相关随访数据。
结论：非隧道化导管的植入式静脉输液港植入术是一项安全的门诊操作，并发症风险较低，可用于缩短手术时长并减轻患者不适感，且不会对手术功能与安全性造成损害。非隧道化导管、穿刺静脉的侧别以及围手术期实施透视检查，均与并发症发生率无显著关联。