Safe and effective ultrasound-guided right IJV chemoport insertion by a BREAST Surgeon in Nepal

Ultrasound-guided chemoport insertion reduces mechanical and infectious complications compared with the landmark-based (blind) insertion technique. However, data are limited from low-resource settings where breast surgeons commonly perform the procedure. This prospective observational study evaluated the safety and outcomes of ultrasound-guided right internal jugular vein (RIJV) chemoport insertion performed by a breast surgeon at a single center in Nepal (November 2023 – May 2025). All procedures were performed in an operating theatre under local anesthesia using a standardized ultrasound-guided Seldinger technique. Among 146 patients scheduled for chemotherapy, 121 patients with breast cancer (mean age 48 ± 11 years; 121 female) underwent successful chemoport implantation (100% cannulation success). Indications were neoadjuvant (40%), adjuvant (59%), and palliative (1%) chemotherapy. No intraoperative complications (e.g., pneumothorax, arterial puncture, hemothorax) occurred. Late complications (5.0%) included port pocket infection (0.8%), port exposure due to skin tension (1.7%), and catheter blockage from delayed flushing (2.5%). Ultrasound-guided RIJV chemoport insertion by a trained breast surgeon is a safe and highly effective procedure with a low complication profile in a resource-limited setting. This supports the integration of this skill into surgical oncology practice, where interventional radiology access is constrained.