Boussen H, Mtaallah M H, Bouzid T, Rifi H, Ben Hassouna J, Kammoun M, Meddeb B, Rahal K
Service de carcinologie médicale, institut Salah-Azaïz, 1006, boulevard du 9-Avril, Tunis, Tunisie.
Arch Pediatr. 2006 Aug;13(8):1107-11. doi: 10.1016/j.arcped.2006.04.007. Epub 2006 May 22.
To report the indications and early and late catheter-related complications in a Tunisian unit of paediatric oncology.
This prospective study has been performed in a paediatric oncology unit of the Salah Azaïz Institute between 1989 and 2005. It concerns 58 girls and 57 boys with a median age of 7.9 years(4 months to 18 years) treated for cancer disease predominantly lymphoma (22%), sarcoma (23.2%) or leukaemia (8.5%) proposed for insertion of a central venous catheter (CVC).
Excluding 2 insertion failures (1.6%), we placed 123 CVC (double for 10 patients), 43 (35%) exteriorised (EC) and 80 (65%) connected to an implantable site (IS). Catheters were placed in the subclavian vein in 59.2% of cases vs 32% for internal jugular vein and 8.8% for femoral vein. Early complications included 15 cases of multiple punctures (12%), 4 cases of pneumothorax (3.2%) and 6 of arterial punctures (4.8%) originating a cervical subcutaneous haematoma in 1 patient (0.8%). Late complications were represented by infection in 7 cases (5.7%). We observed 2 cases of intracardiac catheter migration due to catheter disconnection from the IS (1.6%) and 2 cases of thrombosis (1.8%). The mean life of CVC was longer for IS (305.2 days) than for EC (64.4 days).
Implantable sites are effective progress for venous access in children with cancer. They improved the quality of care in pediatric oncology.
