[Tunnelled central venous catheters in children with cancer. Removal and duration]

Most children with cancer have a tunnelled central venous catheter (CVC) inserted. The optimal type of CVC for children of all ages has not been identified. The purpose of this paper was to analyze factors correlated to the duration of catheterization of the first inserted CVC in children with cancer.

All children with cancer who had their first CVC inserted between 01-01-2000 and 01-09-2006. Retrospective and prospective study of medical charts with respect to the type of CVC, age of the child at insertion, dates of insertion and removal, diagnosis and cause of CVC removal.

Between 01-01-2000 and 01-09-2006 155 double lumen Hickmans (2-Hick) and 86 double lumen Port-a-Caths (2-PaC) were inserted. The total number of CVC days was 27,192 for 2-Hicks and 20,623 for 2-PaCs. The median duration of catherization was significantly longer for 2-PaCs compared with 2-Hicks (200 versus 135 days). Compared with 2-PaCs significantly more 2-Hicks were removed non-electively because of either infections or mechanical complications. The survival of 2-Hicks was significantly shorter in children <5 years of age, but for 2-PaCs there were no correlation between the duration of catherization and the age of the child. 67% of the 2-PaCs were removed at the end of treatment compared with 32% of the 2-Hicks (P< 0,001, chi2 test). A multivariate analysis showed that the type of CVC (P<0,001) and the age of the child (P< 0,001) were independent factors for the duration of the catheterization.

Port-a-Caths for children of all ages with cancer are associated with significantly fewer catheter removals due to complications.