title: [Comparative analysis between the Seldinger technique vs. open dissection in the implantation of intravenous reservoirs].
abstract: OBJECTIVE
  To analyze advantages and disadvantages between Seldinger's technique (ST) and surgical dissection (SD) on intravenous port-a-caths comparing surgical parameters as time and complications.
  
  
  METHODS
  An analytic retrospective study involving historic cohorts was realized, comparing our surgical experience on port-a-cath implantation with Seldinger technique or surgical dissection. Statistical analysis was made reflecting clinical and surgical parameters, such as surgical time length and intra/postoperative complications.
  
  
  RESULTS
  193 Port-a-caths were analyzed (119 SD, 74 ST), mainly placed for chemotherapy treatment (83.41%). Surgical time length expended at single procedures was 72.85 +/- 29.35 minutes for SD and 62.83 +/- 20.08 minutes for ST (p < 0.05). There were none operator-dependent differences. Statistically significant differences were not found between the two cohort's populations, neither at complications percentages. Greater-sized port-a-caths presented a higher average of skin necrosis (p > 0.05) however, lower-sized port-a-caths showed a higher average of infection (16% upon 7.7% p > 0.05). Both ST (51.67 vs. 98.14 min) and SD (78.56 vs. 123.61 min) showed lower surgical time length at left venous accesses (d = 171 vs. i = 19). Average in days for the extraction of port-a-caths with regard to complications was 121 days.
  
  
  CONCLUSIONS
  Seldinger technique reduced the definitive lost of surgical dissected venous accesses, being possible further utilization of the same vein for subsequent port-a-caths. Seldinger technique reduces surgical time length without increasing complication's rate. Left venous access does not imply higher surgical time length. Complications may be related with port-a-cath's size.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla. draspiazu@yahoo.com
authors.forename: D A
authors.initials: DA
authors.lastname: Aspiazu
authors.forename: R
authors.initials: R
authors.lastname: Cabello
authors.forename: I
authors.initials: I
authors.lastname: Tuduri
authors.forename: J
authors.initials: J
authors.lastname: Morcillo
authors.forename: M C
authors.initials: MC
authors.lastname: García-Vallés
authors.forename: J C
authors.initials: JC
authors.lastname: de Agustín
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D062666:Vascular Access Devices; D014656:Vascular Surgical Procedures / Q000379:methods