Insertion technologies for neonatal venous access: a scoping review - Nature

Background: Totally implantable venous access ports (TIVAPs) can be inserted via open venous cutdown or the Seldinger technique. Comparative evidence for safety and efficacy remains mixed, and Australian regional data are limited. Methods: A retrospective observational study of all adult patients undergoing TIVAP or port-a-cath insertion at Goulburn Valley Health, a regional Australian general surgery unit, between January 2019 and December 2024 was conducted. Procedural and postoperative outcomes were compared between open cutdown and Seldinger techniques using Fisher’s exact tests, with unadjusted odds ratios (ORs) and 95% confidence intervals (CIs). Because the use of open cutdown changed over time, sensitivity analyses adjusted for calendar year using Firth’s penalised logistic regression and were restricted to procedures performed during 2023-2024. Results: A total of 127 insertion episodes were included: 42 (33.1%) open cutdown and 85 (66.9%) Seldinger. Use of open cutdown increased over the study period, accounting for 59.4% of procedures during 2023-2024 compared with 1.7% during 2019-2022. First-attempt success (88.1% vs 82.4%; OR 1.58, 95% CI 0.50-6.00), technique convers