{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T17:25:52Z","timestamp":1758475552239,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/100001543","name":"Children's Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001543","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001543","name":"Children's Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001543","id-type":"DOI","asserted-by":"publisher"}]},{"name":"VIVA Foundation for Children with Cancer"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,8,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Surgical trainees performing subclavian vein (SCV) cannulation often incorrectly perceive needle trajectory and anatomical relations. As surface landmark\u2010based methods derived from adult surgical practice may be less effective in younger patients, we developed and evaluated a novel bony landmark\u2010based method for teaching SCV cannulation for central venous access device (CVAD) placement in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Over 2 sequential 3\u2010year periods, pediatric surgical trainees were taught infraclavicular SCV cannulation via surface\u2010 and bony\u2010landmark approaches, respectively. We prospectively recorded patient, surgeon and operative details on all Hickman line and port\u2010a\u2010cath insertions placed by trainees as the first surgeon via percutaneous infraclavicular SCV puncture and compared procedural outcomes and complications across both periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 271 cases included in the study, trainees performed 52 (50.5%) and 92 (54.8%) procedures in the first and second periods, respectively. Patients in both periods did not differ by gender, disease, CVAD device, or prior CVAD, chemotherapy or infection status. In the second (bony landmark) period, although patients were younger (6.0 vs. 8.7 years, <jats:italic>P<\/jats:italic>\u2009=\u20090.003) mean procedural duration was shorter (42.5 vs. 58.3\u00a0min, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Also, cannulation attempts and complication rates did not differ significantly between study periods (<jats:italic>P<\/jats:italic>\u2009=\u20090.257 and 1.0, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With the bony landmark approach, trainees could perform the procedures faster despite operating on younger patients, without impacting complication rates and cannulation attempts. Bony landmarks may better approximate SCV position across a range of ages, thus improving the consistency of SCV cannulation in CVAD placements in children.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-04997-x","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T21:27:31Z","timestamp":1554586051000},"page":"2106-2113","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of a Novel Bony Landmark\u2010Based Method for Teaching Percutaneous Insertion of Subclavian Venous Catheters in Pediatric Patients"],"prefix":"10.1002","volume":"43","author":[{"given":"Zhiyang Jace","family":"Lin","sequence":"first","affiliation":[{"name":"Flinders University School of Medicine Flinders University Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"York Tien","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Paediatric 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Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed Ehsan","family":"Saffari","sequence":"additional","affiliation":[{"name":"Centre for Quantitative Medicine Duke\u2010NUS Medical School Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce Ching Mei","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Paediatric Subspecialties Haematology Oncology Service KK Women's and Children's Hospital Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amos Hong Pheng","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery KK Women's and Children's Hospital 100 Bukit Timah Road 229899 Singapore 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