Имплантируемая порт-система как оптимальный венозный доступ в детской онкологии (М.Ю. Рыков, Е.В. Гьокова, А.З. Дзампаев, Н.А. Сусулёва, В.Г. Поляков)

Introduction. The treatment of any oncologic disease is impossible without a venous access. What kind of properties should it possess? It has to be safe, easy to use, implanted only once during the treatment course and have minimal risks associated with implantation and use. Purpose. Prevention of complications of intravenous chemotherapeutic agent administration. Materials and Methods: From 2010 to 2013 we were monitoring the treatment of 228 children (aged 3 months to 17 years) with oncologic diseases. 110 patients underwent 605 subclavian vein catheterization, 118 patients — 118 venous port implantation. Results. Complications and technical difficulties during catheter insertion were observed in 98,3% of cases, during venous port implantation — in 23% of cases. Complications of subclavian catheter and venous port use were observed in 97,3% and in only 11% of cases, respectively. Subclavian catheters compromised cancer treatment in 45,9% of patients, implantable venous ports — in 1,7% of patients. Each patient with a subclavian catheter underwent central venous catheterization 4 to 19 times (mean 6 times) during treatment. Catheter dwell time exceeded the recommended limit in all patients except for cases of catheter removal by patients. On multiple occasions all patients were discharged with a subclavian catheter in place. Conclusion. Venous ports obviously match the criteria mentioned in the introduction. Subclavian catheter use resulted in cancer treatment protocol deviation in almost 50% of cases, thus leading to a poorer prognosis and significantly increasing the number of invasive procedures and instances where general anesthesia was needed. Key words: pediatric oncology, implantable venous ports, catheter-associated bloodstream infections, chemotherapy. (Onkopediatriya – Oncopediatrics. 2014; 1: 25-31)