Totally Implantable Venous Access Devices In Pediatric Surgery Patients

Jung, Sung Eun; Kim, Yoon Ho; Jun, Yong Sun; Kim, Dae Yeon; Park, Jong Kwon; Lee, Seong Cheol; Park, Kwi Won; Kim, Woo Ki

Abstract

Long-term venous access devices have become an important part of the stantard care for children with malignant disease requiring chemotherapy. Totally implantable venous access system(TIVAS) gained widespread use and acceptance in the management of children with cancer in whom frequent and prolonged venous access is required. We analysed our experiences of insertion and use of totally implantable venous access device in 70 pediatric patients(79 devices), between April 1991 and April 1996. Median age of patients was 6 years and 10 months old. Median duration of utilization was 320 days(range 7-1449 days). Access vein was right external jugular vein(46.8%), left external jugular vein(21.5%), right internal jugular vein(11.4%), left internal jugular vein(3.8%), right subclavian vein(1.3%), left subclavian vein (7.6%), right cephalic vein(2.5%), left cephalic vein(5.1%). Complications related to surgical factors included: wound dehiscence(3 cases), hematoma(1 case), malposition of catheter(1 case). Complications not related to surgical factors included: occlusion of catheter(12 cases), wound infection(7 cases), sepsis(6 cases), leakage(3 cases), hematoma(3 cases), thrombosis of vein (1case). Many complications resolved spontaneously or with medical threatment and 14 cases(17.7%) required removal of system. We conclude that with long-term usage of totally implantable venous access system making it a safe and viable alternative for patients requiring long-term intravenous therapy.