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

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.