Closed cannulation of subclavian vein vs open cut-down of cephalic vein for totally implantable venous access port (TIVAP) implantation: protocol for a systematic review and proportional meta-analysis of perioperative and XXXX .

@entity1 @entity1467 @entity260
BACKGROUND: Totally implantable venous access port (TIVAP) implantation is one of the most often performed operations in general surgery (over 100,000/year in Germany). The two main approaches for TIVAP placement are insertion into the cephalic vein through an @entity1467 ( @entity1467 ) or closed cannulation technique of the subclavian vein (CC) with Seldinger technique. Both procedures are performed with high success rates and very low complication frequencies. Because of the low incidence of complications, no single interventional trial is able to report a valid comparison of peri- and @entity260 frequencies between both techniques. Therefore, the aim of this systematic review is to summarize evidence for peri- and @entity260 rates in @entity1 undergoing @entity1467 or CC. METHODS/DESIGN: A systematic literature search will be conducted in The Cochrane Library, MEDLINE, and Embase to identify randomized controlled trials (RCTs), observational clinical studies (OCS), or case series (CS) reporting peri- and/or @entity260 of at least one implantation technique. A priori defined data will be extracted from included studies, and methodological quality will be assessed. Event rates with their 95% confidence intervals will be derived taking into account the follow-up time per study by @entity1 -months where appropriate. Pooled estimates of event rates with corresponding 95% confidence intervals will be calculated on the base of the Freeman-Tukey double arcsine transformation within a random effect model framework. DISCUSSION: The findings of this systematic review with proportional meta-analysis will help to identify the procedure with the best benefit/risk ratio for TIVAP implantation. This may have influence on daily practice, and data may be implemented in treatment guidelines. Considering the impact of TIVAP implantation on @entity1 ' well being together with its socioeconomic relevance, @entity1 will benefit from evidence-based treatment and health-care costs may also be reduced. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42013005180.
