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  • Title: Totally implantable central venous access devices in pediatric oncology--our experience in 46 patients.
    Author: De Backer A, Vanhulle A, Otten J, Deconinck P.
    Journal: Eur J Pediatr Surg; 1993 Apr; 3(2):101-6. PubMed ID: 8323914.
    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.
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