Venous Access in Treating Children with Cancer: 5-year Experience of the Institute of Pediatric Oncology and Hematology

Introduction. The article presents the five-year experience of implantation and maintenance of venous access systems in children with cancer, and provides the clinical and economic analysis of this type of manipulation. Basing on the sales statistics and the results of the training of medical personnel the analysis of the availability of implantable venous port systems in the clinics of the country was conducted. Materials and methods. The analysis included data on 2,262 patients aged from 2 months up to 17 years, who had been taking a course of chemotherapy in 2010-2014 and were implanted different venous access systems: 2099 children (92.8%) — 3930 external central venous catheters and 163 (7.2%) — 163 implantable venous port systems. Results. Complications in patients with external central venous catheter occurred in 11.8% of cases, technical difficulties — in 72.9%, 55.8% of which were corrected intraoperatively. Maintenance complications were noted in 61.7% of cases, 44% of which required removal of the outer central venous catheters. Complications in patients with implanted port systems occurred in 4.3% of cases, technical difficulties — in 29.4% but all the complications were corrected intraoperatively. Maintenance complications were noted in 15.9% of patients. They were caused by improper operation of the port systems. It resulted in the removal of 2.4% port systems. Conclusion. Maintenance of implantable venous port systems carries the lowest risk of complications, and is more economical. One of the few deterrents for their mass adoption is the lack of a sufficient number of qualified medical personnel able to deal with the implantation and maintenance of long-term venous access. Another reason — the lack of required radiological and ultrasound equipment in clinics.