Why do subcutaneous ports get stuck? A case-control study

Area of Science:

• Pediatric Surgery
• Oncology
• Medical Devices

Background:

• Subcutaneous ports are essential for long-term venous access in pediatric patients, particularly those undergoing chemotherapy.
• Complications, such as difficult port removal, can prolong procedures and increase morbidity.

Purpose of the Study:

• To identify clinical features associated with difficult (stuck) subcutaneous port removals in children.
• To inform strategies for managing and preventing port removal complications.

Main Methods:

• A prospective case-control study was conducted, comparing children with stuck ports to age- and sex-matched controls.
• Logistic regression and multivariable analysis were used to identify independent predictors of difficult port removal.

Main Results:

• Stuck ports were significantly associated with a diagnosis of acute lymphoblastic leukemia (ALL) and longer duration of port placement.
• Factors such as subclavian vein access, polyurethane catheter material, and rough catheter appearance at removal were linked to difficult removals.
• A diagnosis of ALL and prolonged line placement duration were independent predictors of stuck ports.

Conclusions:

• Polyurethane central venous catheters used for the treatment of ALL may be prone to difficult removal.
• These findings suggest a need for enhanced preoperative risk assessment, consideration of endovascular backup, and optimized operating room scheduling for these patients.