Kılıç Sinan, Soyer Tutku, Karnak İbrahim, Çiftçi Arbay Özden, Tanyel Feridun Cahit, Şenocak Mehmet Emin
Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2016;58(2):187-194. doi: 10.24953/turkjped.2016.02.010.
Totally implantable venous access devices (TIVADs) increase the quality of life in children with hematologic and oncologic diseases or organ failures. The aim of this study is to determine the reasons for port removal. The port catheters, implanted and removed in patients between January 2000 and June 2013 were evaluated retrospectively. The patients were divided into two groups, whose port catheters were removed due to completed therapy (completed therapy group, CTG) and whose port catheters were removed because of a port catheter-related complications (complication group, CG). In the CG, the patients whose port catheters are removed for infectious reasons are investigated for whether there is a relationship with age, gender, body mass index (BMI), height and weight at the time of port implantation and removal. In total, 242 patients who underwent port implantation and removal were included in the study. The male to female ratio was 1.32/1 and the mean age of the patients was 9.4±4.9 years (0-24 year). Patients were enrolled in CTG (n=170, 70.2%), and CG (n=72, 29%). There is a positive correlation between BMI and infections (p < 0.05). In the CG, patients under steroid treatment had higher incidence of non-infectious causes than infectious causes (p < 0.05). Oppositely, non infectious complications were higher in steroid free patients (p < 0.05). There was no catheter related mortality in the entire study group. The hematological malignancies and solid tumors are the most common underlying primary disease in patients with port removal because of complications. Infectious complications are most common cause of port removal in children and despite other microorganism, fungi should be considered as a cause of catheter related infections.
完全植入式静脉通路装置(TIVADs)提高了患有血液学和肿瘤学疾病或器官衰竭儿童的生活质量。本研究的目的是确定拔除端口的原因。回顾性评估2000年1月至2013年6月期间患者植入和拔除的端口导管。患者分为两组,一组其端口导管因治疗结束而拔除(治疗结束组,CTG),另一组其端口导管因与端口导管相关的并发症而拔除(并发症组,CG)。在CG组中,对因感染原因拔除端口导管的患者,调查其在端口植入和拔除时与年龄、性别、体重指数(BMI)、身高和体重是否存在关联。本研究共纳入242例接受端口植入和拔除的患者。男女比例为1.32/1,患者平均年龄为9.4±4.9岁(0 - 24岁)。患者被纳入CTG组(n = 170,70.2%)和CG组(n = 72,29%)。BMI与感染之间存在正相关(p < 0.05)。在CG组中,接受类固醇治疗的患者非感染性原因的发生率高于感染性原因(p < 0.05)。相反,未使用类固醇的患者非感染性并发症更高(p < 0.05)。整个研究组中没有与导管相关的死亡病例。血液系统恶性肿瘤和实体瘤是因并发症而拔除端口的患者中最常见的潜在原发疾病。感染性并发症是儿童拔除端口最常见的原因,除其他微生物外,真菌应被视为导管相关感染的一个原因。