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Introduction: Totally Implantable Venous Access Devices (TIVADs) contribute significantly to the treatment progress and comfort of patients requiring long-term therapy. However, the procedure for implanting TIVADs, as well as its very presence, may be associated with complications. Aim: This study evaluates the indications, safety, and complication rates of venous port implantations in pediatric patients. It also explores factors influencing the occurrence of early and late complications post-implantation. Materials and methods: The study included 383 pediatric patients treated at the Department of Pediatric Surgery, Traumatology, and Urology in Poznan between 2013 and 2020 who underwent 474 implantations of intravenous ports. Venous access was achieved using the Seldinger technique. Statistical analysis was performed using Statistica 13 with TIBCO and PQStat 1.8.2.156 with PQStat. Results: Venous ports were used in 345 oncology patients requiring chemotherapy (90% of the total group) and in 38 children (10%) with non-oncology indications. There were 36 early complications (7.6%) and 18 late complications (3.8%), excluding infectious complications. The most common early, non-infectious complications included pneumothorax (15 patients; 3%) and port pocket hematoma (12 patients; 2.5%). The most common late, non-infectious complications observed were venous catheter obstruction (8 children; 1.7%) and port system leakage (5 children; 1%). Infectious complications occurred in 129 cases (27.2%). Children with a diagnosis of non-Hodgkin's lymphoma, acute myeloid leukemia, and acute lymphoblastic leukemia had a significantly higher incidence of port infections. Venous ports equipped with a polyurethane catheter, compared to systems with a silicone catheter, functioned significantly shorter. Conclusions: The Seldinger method of port implantation is quick, minimally invasive, and safe. The type of port, including the material of the port's venous catheter, and the underlying disease have an impact on the durability of implantable intravenous systems. The experience of the surgeon is related to the frequency of complications associated with the procedure.
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<b> Introduction: </b> Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a procedure which enables reconstruction of the continuity of the gastrointestinal track after resection of the large intestine and rectum. The most common diseases that require this type of resection include: ulcerative colitis and familial adenomatous polyposis. </br></br> <b>Aim:</b> The study aimed to determine the effectiveness of IPAA in the surgical treatment of the paediatric age group. </br></br> <b>Material and methods:</b> The research material was collected based on medical records of 21 patients who underwent proctocolectomy at the Department of Pediatric Surgery, Traumatology, and Urology of the Medical University of Poznan in 2000-2021. </br></br> <b>Results: </b> In a group of 21 patients, 11 children were qualified for proctocolectomy due to ulcerative colitis (UC), 6 due to familial adenomatous polyposis (FAP), 3 due to Hirschsprung's disease (HD), and one child due to Crohn's disease (CD). Early complications in treated patients included dehiscence of the postoperative wound, bleeding from the lower gastrointestinal tract and anastomotic leakage. Late complications included pouchitis, stenosis of the ileostomy, narrowing of the anastomotic site and soiling. Quality of life was rated at an average of 9-10 by 16 patients on a scale of 1-10. </br></br> <b>Conclusions:</b> IPAA is a proven method of reconstruction for the paediatric age group requiring proctocolectomy. Complications are common, most often related to the underlying disease and the clinical condition of the patients. Despite possible complications, patients rate their quality of life high on the scale. Each qualification for surgery should be carried out in a multidisciplinary team.
