A comparison of placement techniques and complications of externalized catheters and implantable port use in children with cancer

The complications associated with the placement and use of Hickman catheters (n=120). Broviac catherers (n=146), and implantable ports (n=93) in children with cancer were analyzed. Percutaneously placed central venous access devices (CVADs) tended to fail less often ( P=.86) and to develop infections less often ( P=.056) than surgically placed CVADs. The difference im complications with percutaneous versus surgically placed CVADs requires confirmation in a randomized trial to assure they are not a result of differences in patient characteristics. When all catheter failures (removal due to infection, obstruction, or dislodgement) were considered, ports had a significantly longer failure-free duration of use than externalized Hickman and Broviac catheters ( P=.0009). Ports also remained infection-free longer than externalized catheters ( P=.0014). The greatest risk of infection occurs in the first 100 days of use, particularly for ports. This study demonstrates that for long-term use (greater than 100 days) ports are superior to externalized catheters in children with cancer.