Dislodgement of port-A catheters in pediatric oncology patients: 11 years of experience

World Journal of Surgical Oncology

Jiunn-Ming Sheen³  Jiin-Haur Chuang²  Yu-Chieh Chen³  Chih-Chen Hsiao³  Sheung-Fat Ko¹  Shin-Yi Lee²  Chiu-Ping Hou³  Chia-Hui Tsai³  Su-Chen Wang³ 

[1] Department of Radiology, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Niao-Sung, Kaohsiung 833, Taiwan;Department of Pediatric Surgery, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University College of Medicine, Niao-Sung, Kaohsiung 833, Taiwan;Department of Pediatrics, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University College of Medicine, Niao-Sung, Kaohsiung 833, Taiwan

关键词: Transcatheter retrieval;    Port-A catheter;    Dislodgement;    Children;   

Others  :  823437
DOI  :  10.1186/1477-7819-11-191

 received in 2013-03-30, accepted in 2013-08-04,  发布年份 2013

【 摘 要 】

Background

Port-A catheters are frequently used in pediatric cancer patients. Their dislodgement is potentially seriously risky although the incidence is not high. We analyzed our 11 years of data to address this important problem.

Methods

From January 2001 to December 2011, 330 port-A catheters of different brands were implanted in pediatric cancer patients. In total, eight children suffered a dislodgement of their catheter. Their ages ranged from four to thirteen years, with a median age of ten. Five patients presented with catheter dysfunction, two presented with a cough and one was identified incidentally during surgery to remove his port.

Results

The downstream ends of the dislodged catheters were located in the right atrium (three patients), left pulmonary artery (three) and inferior vena cava (two). Six of the eight catheters were broken at the site of anastomosis to the port and the other two were broken halfway in between. All episodes of dislodgement happened after the chemotherapy regimen was completed. The dislodged catheters were successfully retrieved without complications by transcatheter retrieval using a gooseneck snare.

Conclusions

The dislodgment rate of port-A catheter in our series was 2.4%. Chest X-rays can rapidly detect the problem. Most of the catheters were broken at the site of anastomosis. Earlier explantation of port-A catheters after completing chemotherapy may be considered to avoid the dislodgement of catheters, but this needs to be weighed against the possibility of underlying disease recurrence. However, we should re-examine how long port-A catheters need to be retained after chemotherapy considering the improved cure rate of pediatric cancer.

【 授权许可】

   
2013 Wang et al.; licensee BioMed Central Ltd.

【 图 表 】

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Figure 2.

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