CENTRAL VENOUS ACCESS LINES IN PEDIATRIC ONCOLOGY FROM THE SURGICAL POINT-OF-VIEW

A total of 307 central venous access devices were implanted by open su rgery in 268 pediatric oncology patients. Their data were retrospectiv ely evaluated from a surgical point of view. The cumulative duration o f implantation of 116 subcutaneous tunneled Catheter (STC) was 12206 d ays and 45 524 days for 191 portsystems. According to the duration in each group, ports were superior to STC when infection, complication an d occlusion were taken into consideration. Infection of the ports was more frequent in children under 3 years than in older patients. Conver sely, in the STC-group, children over 10 years presented with the high est rate of infection episodes. The number of complications was high i n young children for both types of catheter, decreasing with age. Occl usion rates were similar for both systems and were not age related. Ho wever, thrombolysis was more successful in portsystems and few cathete rs had to be removed for this reason. The agerelated data of the prese nted study are discussed with regard to the surgical procedure. Recomm endations are made concerning the adequate choice of catheter system, the surgical technique and postoperative management. Additionally, the medicotechnical aspect of different catheter types is discussed and s ome suggestions and/or requests are directed to the industrial develop ing laboratories.