title: Totally implantable central venous access devices in pediatric oncology--our experience in 46 patients.
abstract: Between 1986 and 1990, 50 venous access devices have been implanted in 45 children with various types of cancer and in one patient with Langerhans cell histiocytosis. Twenty-five devices were of the so-called "pediatric" type (Port-A-Cath: 24, Vascuport: 1) and 25 were "adult" ports (Port-A-Cath: 8, Vascuport: 6, Infuse-A-Port: 6, Theraport: 5). The catheters (in silicone elastomer or polyurethane) were inserted percutaneously or surgically. Cumulative total venous access was 15024 patient-days (mean: 290 days per patient, range 2-900 days). Occlusion of the system, the most frequent complication, was encountered in 5 patients (11%). Rarer complications were catheter-related infection (2 pts), pneumothorax (1 pt), skin necrosis (1 pt), catheter leakage (1 pt) and port-catheter disconnection (1 pt). No serious complication ever occurred in 35 patients (76%). Seven of the 11 complications, including all 3 port occlusions, were encountered with "pediatric" systems. All the adult access devices tested were safe and allowed long-standing access to the central venous system in this series of pediatric cancer patients. With proper placement technique and adequate nursing care, they represent a definite improvement in child cancer therapy.
authors.affiliation: Division of Pediatric Surgery, Academic Children's Hospital, Free University of Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: De Backer
authors.forename: A
authors.initials: A
authors.lastname: Vanhulle
authors.forename: J
authors.initials: J
authors.lastname: Otten
authors.forename: P
authors.initials: P
authors.lastname: Deconinck
mesh_terms: D000293:Adolescent; D001800:Blood Specimen Collection / Q000295:instrumentation; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007223:Infant; D015918:Infusion Pumps, Implantable; D007938:Leukemia / Q000628:therapy*; D008297:Male; D009369:Neoplasms / Q000628:therapy*