Blind percutaneous insertion of Hickman lines by a specialist team

Abstract

Background: Long-term intravenous lines for the delivery of chemotherapy can be inserted by the percutaneous route or under direct vision by surgical exploration. Though the percutaneous route is widely used, many centres still employ a surgical approach. This study evaluates the safety of the blind percutaneous approach. Method: Prospective records were kept of all Hickman lines inserted on the oncology unit of a large teaching hospital. Results: 127 consecutive lines were inserted in 115 adults by a single surgeon over a 30 month period using a blind percutaneous approach. There were 4 complications of insertion: 2 pneumothoraces (1.6%), 1 arrhythmia (0.8%) and bleeding from the subcutaneous tunnel (0.8%). Only 1 line had to be removed in the first 14 days because of hub fracture and leakage. Conclusions: Percutaneous insertion of Hickman lines using the blind technique is associated with a low incidence of complications when performed by an experienced operator