[Central venous indwelling catheter systems in pediatric oncology from the surgical viewpoint]

A total of 307 central venous access devices were implanted by open surgery in 268 pediatric oncology patients. Their data were retrospectively evaluated from a surgical point of view. The cumulative duration of implantation of 116 subcutaneous tunneled Catheter (STC) was 12,206 days and 45,524 days for 191 portsystems. According to the duration in each group, ports were superior to STC when infection, complication and occlusion were taken into consideration. Infection of the ports was more frequent in children under 3 years than in older patients. Conversely, in the STC-group, children over 10 years presented with the highest rate of infection episodes. The number of complications was high in young children for both types of catheter, decreasing with age. Occlusion rates were similar for both systems and were not age related. However, thrombolysis was more successful in portsystems and few catheters had to be removed for this reason. The age-related data of the presented study are discussed with regard to the surgical procedure. Recommendations 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 some suggestions and/or requests are directed to the industrial developing laboratories.