Image and intracavitary electrocardiogram-guided arm port placement in colorectal cancer: A retrospective comparative study

doi:10.4240/wjgs.v17.i10.109407

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Oct 27, 2025; 17(10): 109407
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.109407

Image and intracavitary electrocardiogram-guided arm port placement in colorectal cancer: A retrospective comparative study

Gui-Lan Xie, Jing Heng, Xiu-Fen Jia, Qian Li, Rui Chang, Nan Zhang, Ling-Ling Xie, Chao Gao

Gui-Lan Xie, Chao Gao, School of Nursing, Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China

Gui-Lan Xie, Jing Heng, Qian Li, Rui Chang, Nan Zhang, Ling-Ling Xie, Chao Gao, Department of Oncology, Xuzhou Medical University, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China

Xiu-Fen Jia, Nursing Clinic, Xuzhou Medical University, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China

Co-first authors: Gui-Lan Xie and Jing Heng.

Co-corresponding authors: Ling-Ling Xie and Chao Gao.

Author contributions: Xie GL and Heng J conceptualized and designed the study, performed data collection and statistical analysis, drafted, and revised the manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Jia XF coordinated nursing protocols and patient follow-up procedures, contributed to data collection; Li Q, Chang R, and Zhang N participated in patient recruitment, clinical procedures, and outcome assessment; Xie LL and Gao C supervised the study design and implementation, provided clinical oversight, and critically revised the manuscript, they contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors approved the final version and agree to be accountable for all aspects of the work.

Supported by the Affiliated Hospital of Xuzhou Medical University, No. 2024ZH04; and Xuzhou Municipal Science and Technology Bureau, No. KC23282.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the Affiliated Hospital of Xuzhou Medical University, approval No. XYFY2024-KL084-01).

Informed consent statement: The requirement for individual informed consent was waived due to the use of de-identified data and the minimal-risk nature of the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Chao Gao, School of Nursing, Xuzhou Medical University, No. 209 Tongshan Road, Yunlong District, Xuzhou 221000, Jiangsu Province, China. gc19682025@163.com

Received: June 17, 2025
Revised: July 22, 2025
Accepted: September 2, 2025
Published online: October 27, 2025
Processing time: 128 Days and 22.8 Hours

Abstract

BACKGROUND

Arm-implanted totally implantable venous access devices (peripherally inserted central catheter port) have become an important vascular access for colorectal cancer chemotherapy, but traditional anatomical landmark positioning techniques have issues with inaccurate positioning and high complication rates.

AIM

To evaluate the clinical value of image pre-measurement combined with intracavitary electrocardiogram (IC-ECG) positioning technology in arm port implantation for colorectal cancer patients.

METHODS

A retrospective analysis was conducted on 216 colorectal cancer patients who received arm port implantation in our hospital from January 2024 to December 2024. Patients were divided into an experimental group (image pre-measurement combined with IC-ECG positioning technology, n = 103) and a control group (traditional anatomical landmark positioning technique, n = 113). Technical success rate, operation time, catheter tip position accuracy, number of intraoperative catheter adjustments, X-ray exposure time, and postoperative complication rates were compared between the two groups.

RESULTS

The experimental group demonstrated superior outcomes compared to the control group across all key measures. Technical success rate was higher (98.4% vs 92.7%, P < 0.05) with significantly reduced operation time (23.6 ± 5.2 minutes vs 31.5 ± 7.8 minutes, P < 0.01). Catheter tip positioning accuracy improved substantially (97.6% vs 85.4%, P = 0.002) while X-ray exposure time decreased by 71.8% (5.3 ± 2.1 seconds vs 18.7 ± 4.5 seconds, P < 0.001). Three-month complication rates were markedly lower in the experimental group (4.1% vs 14.6%, P = 0.008), including significant reductions in catheter-related thrombosis (0.8% vs 4.9%), displacement (1.6% vs 5.7%), and occlusion (1.6% vs 4.1%). Multivariate analysis identified traditional technique as the strongest risk factor (odds ratio = 4.27, P < 0.001), while the combined IC-ECG approach was protective (odds ratio = 0.34 for displacement, P = 0.018). Long-term outcomes favored the experimental group with higher chemotherapy completion rates (97.1% vs 88.5%, P = 0.014) and longer catheter dwelling time (189.5 ± 45.3 days vs 162.7 ± 53.8 days, P < 0.001).

CONCLUSION

Image pre-measurement combined with intracavitary electrocardiogram positioning technology in arm port implantation for colorectal cancer patients can significantly improve catheter tip positioning accuracy, reduce operation time and X-ray exposure.

Keywords: Arm port; Colorectal cancer; Image pre-measurement; Intracavitary electrocardiogram; Catheter tip positioning; Complications

Core Tip: This study demonstrates that combining image pre-measurement with intracavitary electrocardiogram positioning significantly improves the accuracy, efficiency, and safety of arm port implantation in colorectal cancer patients. Compared with traditional anatomical landmark methods, this technique reduces operation time, X-ray exposure, and catheter-related complications. It is particularly beneficial for high-risk groups such as female patients, those with high body mass index, and advanced-stage tumors. The findings support broader clinical adoption of this technique to enhance vascular access outcomes in oncology care.