title: Successful use of indwelling tunneled catheters for the management of effusions in children with advanced cancer.
abstract: BACKGROUND
  Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer.
  
  
  METHODS
  Children with MPE/MA who underwent ITC insertion (2007-2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed.
  
  
  RESULTS
  PleurX® ITCs (n = 12) were inserted in eight patients (5-18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n = 1), late site infection (n = 1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ.
  
  
  CONCLUSIONS
  ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home.
authors.affiliation: Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Pediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, University of Rotterdam, Rotterdam, The Netherlands.
authors.forename: Barbara S
authors.initials: BS
authors.lastname: den Hollander
authors.forename: Bairbre L
authors.initials: BL
authors.lastname: Connolly
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.forename: Adam
authors.initials: A
authors.lastname: Rapoport
authors.forename: C M
authors.initials: CM
authors.lastname: Zwaan
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Grant
authors.forename: Dimitri
authors.initials: D
authors.lastname: Parra
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Temple
mesh_terms: D000293:Adolescent; D001201:Ascites / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D055499:Catheter-Related Infections / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D010166:Palliative Care; D019152:Paracentesis; D010342:Patient Acceptance of Health Care; D016066:Pleural Effusion, Malignant / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D018700:Pleurodesis; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D012509:Sarcoma / Q000150:complications
keywords: ascites; catheters; indwelling; malignant; pediatric oncology; pleural effusion