[Application of long term subcutaneously implanted access into the central veins system of "PORT" type in the Clinic of Pediatry, Pediatric Hematology and Oncology in Zabrze--15 year own observations]. / Zastosowanie dlugoterminowego, implantowanego podskórnie akcesu do ukladu zyl centralnych typu "PORT" w Klinice Pediatrii, Hematologii i Onkologii Dzieciecej w Zabrzu--15 lat obserwacji wlasnych.

ABSTRACT

INTRODUCTION: Long term disease treatment in children is a very special medical problem due to a necessity of maintaining an efficient venous access for many months and even years. Vascular ports applied in those children improved the conditions of treatment and a quality of life, additionally, made the job of personnel taking care of them easier. MATERIAL AND METHODS: The study presents own experience in long-term venous access into the central veins system, so called vascular ports, gathered for 15 years of using them in children with hemato-oncogical diseases. The analysis of 309 of implanted vascular ports was done taking into consideration the maintenance and complications. Ports were implanted in 300 children with oncological diseases. The received results are presented in numbers and percentage. RESULTS: Mean time of port insertion has decreased in comparison to earlier studies by 35 days and now is 722 days, median 658 days, however, minimal and maximal time of port insertion has changed respectively 7 and 2099 days. The total time of port insertion in this period was 232 536 days. The observation showed 31 (10.03%) cases of complications, out of which the most common were set infection (16 - 5.18%), catheter occlusion by a clot (7 - 2.27%) and "spontaneous" catheter move out of vessel lumen (3 - 0.97%), migration of a torn-off catheter into the right heart ventricle (2 - 0.65%). CONCLUSIONS: 1. Application of vascular ports enabled a long-term and intensive chemotherapy in children with oncological and hematological diseases. 2. Application of vascular ports bears a minor risk of complications, the most dangerous observed complication was a replacement of a torn-off catheter into the right heart ventricle.