{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:03:26Z","timestamp":1792782206387,"version":"4.5.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2009,1,21]],"date-time":"2009-01-21T00:00:00Z","timestamp":1232496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Heidelberg Surgical Foundation and Fresenius Kabi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Totally implantable access ports (TIAPs) are often used for patients who need permanent venous access. The primary success rate using direct open insertion is about 80 per cent, so rescue strategies are needed. This study compared the primary success rates of standard open insertion and a modified Seldinger technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized trial recruited 164 patients scheduled for primary implantation of a TIAP and compared two interventions. The primary endpoint was the success rate of the implantation technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The primary success rates were similar: 66 (80 per cent) of 82 patients who had standard open insertion versus 69 (84 per cent) of 82 patients undergoing the modified Seldinger method (P = 0\u00b7686). A logistic mixed regression analysis including treatment group, age, Karnofsky index, body mass index and surgeon's experience showed no advantage for the Seldinger method: odds ratio 1\u00b730 (95 per cent confidence interval 0\u00b762 to 2\u00b770). TIAPs were eventually implanted successfully in 163 (99\u00b74 per cent) of 164 patients. In 11 patients randomized to standard surgery, the Seldinger method was a successful rescue strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The primary success rate was similar for both open insertion methods. The modified Seldinger method is useful if standard open insertion fails. Registration number: ISRCTN 52368201 (http:\/\/www.controlled-trials.com).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.6457","type":"journal-article","created":{"date-parts":[[2009,1,21]],"date-time":"2009-01-21T07:01:16Z","timestamp":1232521276000},"page":"159-165","source":"Crossref","is-referenced-by-count":34,"title":["Randomized clinical trial of a modified Seldinger technique for open central venous cannulation for implantable access devices"],"prefix":"10.1093","volume":"96","author":[{"given":"P","family":"Knebel","sequence":"first","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Huesing","sequence":"additional","affiliation":[{"name":"Coordination Centre for Clinical Trials, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Hennes","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M W","family":"B\u00fcchler","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C M","family":"Seiler","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,1,21]]},"reference":[{"key":"2021070906471763800_bib1","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1001\/archsurg.136.9.1050","article-title":"Totally implantable venous access devices implanted surgically: a retrospective study on early and late complications","volume":"136","author":"Di Carlo","year":"2001","journal-title":"Arch Surg"},{"key":"2021070906471763800_bib2","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.jhin.2005.08.019","article-title":"Infectious complications of implantable ports and Hickman catheters in paediatric haematology\u2013oncology patients","volume":"62","author":"Adler","year":"2006","journal-title":"J Hosp Infect"},{"key":"2021070906471763800_bib3","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.clon.2007.04.003","article-title":"A comparison of Hickman line- and Port-a-Cath-associated complications in patients with solid tumours undergoing chemotherapy","volume":"19","author":"Ng","year":"2007","journal-title":"Clin Oncol (R Coll Radiol"},{"key":"2021070906471763800_bib4","first-page":"602","article-title":"A silicone rubber atrial catheter for prolonged parenteral alimentation","volume":"136","author":"Broviac","year":"1973","journal-title":"Surg Gynecol Obstet"},{"key":"2021070906471763800_bib5","first-page":"871","article-title":"A modified right atrial catheter for access to the venous system in marrow transplant recipients","volume":"148","author":"Hickman","year":"1979","journal-title":"Surg Gynecol Obstet"},{"key":"2021070906471763800_bib6","first-page":"706","article-title":"Totally implanted venous and arterial access system to replace external catheters in cancer treatment","volume":"92","author":"Niederhuber","year":"1982","journal-title":"Surgery"},{"key":"2021070906471763800_bib7","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/1471-2407-5-37","article-title":"Phase III trial of postoperative cisplatin, interferon alpha-2b, and 5-FU combined with external radiation treatment versus 5-FU alone for patients with resected pancreatic adenocarcinoma\u2014CapRI: study protocol ISRCTN62866759","volume":"5","author":"Knaebel","year":"2005","journal-title":"BMC Cancer"},{"key":"2021070906471763800_bib8","volume-title":"Fallpauschalenbezogene Krankenhausstatistik (DRG-Statistik)","author":"Statistisches Bundesamt","year":"2006"},{"key":"2021070906471763800_bib9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1177\/112972980200300302","article-title":"Central venous long-term access implant in oncology patients: is there a gold standard? A critical analysis of available evidence","volume":"3","author":"Biffi","year":"2002","journal-title":"J Vasc Access"},{"key":"2021070906471763800_bib10","first-page":"131","article-title":"[Anatomical basis for the surgical use of the cephalic vein (V. Cephalica). 74 anatomical dissections. 189 surgical dissections]","volume":"120","author":"Le Saout","year":"1983","journal-title":"J Chir (Paris)"},{"key":"2021070906471763800_bib11","first-page":"673","article-title":"Insertion of Hickman catheters. A comparison of cutdown and percutaneous techniques","volume":"50","author":"Davis","year":"1984","journal-title":"Am Surg"},{"key":"2021070906471763800_bib12","first-page":"163","article-title":"Placement of Hickman\u2013Broviac catheters in the cephalic vein","volume":"166","author":"Chuter","year":"1988","journal-title":"Surg Gynecol Obstet"},{"key":"2021070906471763800_bib13","first-page":"638","article-title":"The anatomy of the cephalic vein","volume":"55","author":"Au","year":"1989","journal-title":"Am Surg"},{"key":"2021070906471763800_bib14","first-page":"218","article-title":"Direct cephalic vein cannulation for safe subclavian access","volume":"35","author":"Perry","year":"1990","journal-title":"J R Coll Surg Edinb"},{"key":"2021070906471763800_bib15","first-page":"323","article-title":"The complications of central venous access systems: a study of 218 patients","volume":"159","author":"Torramad\u00e9","year":"1993","journal-title":"Eur J Surg"},{"key":"2021070906471763800_bib16","first-page":"171","article-title":"Placement of a double lumen silastic catheter for hemodialysis access through the cephalic vein","volume":"178","author":"Gallichio","year":"1994","journal-title":"J Am Coll Surg"},{"key":"2021070906471763800_bib17","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1007\/s10434-000-0496-9","article-title":"A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients","volume":"7","author":"Povoski","year":"2000","journal-title":"Ann Surg Oncol"},{"key":"2021070906471763800_bib18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1002\/jso.20410","article-title":"Surgical technique for totally implantable access ports (TIAP) needs improvement: a multivariate analysis of 400 patients","volume":"93","author":"Seiler","year":"2006","journal-title":"J Surg Oncol"},{"key":"2021070906471763800_bib19","first-page":"429","article-title":"A safe technique for the placement of implantable vascular access devices in patients with thrombocytopenia","volume":"167","author":"Coit","year":"1988","journal-title":"Surg Gynecol Obstet"},{"key":"2021070906471763800_bib20","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1002\/jso.20584","article-title":"Guidewire assisted cephalic vein cutdown for insertion of totally implantable access ports","volume":"95","author":"Chang","year":"2007","journal-title":"J Surg Oncol"},{"key":"2021070906471763800_bib21","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1745-6215-7-20","article-title":"Comparison of Venae Sectio vs. modified Seldinger Technique for totally implantable access ports; Portas-trial (ISRCTN:52368201)","volume":"7","author":"Knebel","year":"2006","journal-title":"Trials"},{"key":"2021070906471763800_bib22","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1002\/jso.20555","article-title":"Surgical technique for totally implantable access ports (TIAP) needs improvement","volume":"95","author":"Karakousis","year":"2007","journal-title":"J Surg Oncol"},{"key":"2021070906471763800_bib23","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1148\/radiology.184.1.1609072","article-title":"Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access","volume":"184","author":"Morris","year":"1992","journal-title":"Radiology"},{"key":"2021070906471763800_bib24","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/S1051-0443(97)70699-7","article-title":"Outcome of 350 implanted chest ports placed by interventional radiologists","volume":"8","author":"Shetty","year":"1997","journal-title":"J Vasc Interv Radiol"},{"key":"2021070906471763800_bib25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S1051-0443(97)70537-2","article-title":"Interventional radiologic placement of chest wall ports: results and complications in 161 consecutive placements","volume":"8","author":"Simpson","year":"1997","journal-title":"J Vasc Interv Radiol"},{"key":"2021070906471763800_bib26","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1055\/s-2007-1015051","article-title":"[The fluoroscopy-guided implantation of subcutaneous venous ports: the complications and long-term results]","volume":"169","author":"Kluge","year":"1998","journal-title":"Rofo"},{"key":"2021070906471763800_bib27","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/S1051-0443(99)70066-7","article-title":"Long-term follow-up of upper extremity implanted venous access devices in oncology patients","volume":"10","author":"Lyon","year":"1999","journal-title":"J Vasc Interv Radiol"},{"key":"2021070906471763800_bib28","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1007\/s002700001721","article-title":"Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients","volume":"24","author":"Lorch","year":"2001","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2021070906471763800_bib29","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1245\/s10434-007-9783-z","article-title":"Reasons for explantation of totally implantable access ports: a multivariate analysis of 385 consecutive patients","volume":"15","author":"Fischer","year":"2008","journal-title":"Ann Surg Oncol"},{"key":"2021070906471763800_bib30","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1002\/1097-0142(20010901)92:5<1204::AID-CNCR1439>3.0.CO;2-9","article-title":"A randomized, prospective trial of central venous ports connected to standard open-ended or Groshong catheters in adult oncology patients","volume":"92","author":"Biffi","year":"2001","journal-title":"Cancer"},{"key":"2021070906471763800_bib31","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/1745-6215-9-60","article-title":"Protocol of an expertise based randomized trial comparing surgical Venae Sectio versus radiological Puncture of Vena Subaclavia for insertion of Totally Implantable Access Port in oncological patients","volume":"9","author":"Knebel","year":"2008","journal-title":"Trials"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.6457","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/96\/2\/159\/36639095\/bjs6457.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/96\/2\/159\/36639095\/bjs6457.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T11:38:45Z","timestamp":1625830725000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/96\/2\/159\/6150195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,1,21]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2009,1,21]]},"published-print":{"date-parts":[[2009,1,21]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.6457","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2009,2]]},"published":{"date-parts":[[2009,1,21]]}}}