Evaluation of the removal reasons of totally implantable venous devices in children: a retrospective study

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.