Paediatric Oncology Unit, Hospital Infantil Universitario La Fe, Avenida de Campanar 21, 46009 Valencia, Spain.
J Pediatr Surg. 2010 Jul;45(7):1491-5. doi: 10.1016/j.jpedsurg.2010.02.001.
There are few reports regarding the presence of retained fixed fragments after removal of indwelling central venous catheters in children. We conducted a retrospective study of 355 patients who underwent removal of central venous catheter from 1996 to 2008. Six patients (1.6%) had a failed attempt of removal, resulting in a remnant of catheter left in the central venous system. All of them had underlying malignant disorders and received chemotherapy for a prolonged period of time. In 2 patients, a second attempt of retrieval was performed that was partially successful. After an average follow-up of 3.5 +/- 1.8 years, 1 patient has developed mild symptoms that could be related to the remaining fragment within the vascular system. Therefore, the incidence of complications caused by retained fixed fragments is low. Patients whose line has been in place for more than 48 months (P = 0.009) and those located in the saphenous vein (P = 0.01) are more prone to experience fragment retention. The decision of retrieval should be balanced according to the presence of symptoms and the length of the fragment retained.
在儿童留置中心静脉导管取出后,很少有报道称存在固定碎片残留。我们对 1996 年至 2008 年期间接受中心静脉导管取出的 355 例患者进行了回顾性研究。6 例(1.6%)患者在取出过程中失败,导致导管残留在中心静脉系统中。他们均患有恶性疾病,并接受了长时间的化疗。其中 2 例患者进行了第二次取回尝试,部分成功。平均随访 3.5+/-1.8 年后,1 例患者出现了可能与血管系统内残留碎片相关的轻度症状。因此,由固定碎片残留引起的并发症发生率较低。导管留置时间超过 48 个月的患者(P=0.009)和位于隐静脉的患者(P=0.01)更容易出现碎片残留。是否进行取回操作应根据症状的存在和残留碎片的长度来权衡。