Complicated Surgical Removal of an Adherent Port-a-Cath After 11 Years of Implantation

Removal of the central venous port system in children. Is this an appropriate training procedure for resident physicians? A single-center retrospective study

<b>Introduction:</b> A venous port system consists of a port chamber attached to a central catheter, which is implanted into the central venous system. The removal of the vascular port includes all items of this system. This procedure is usually simple and quick. Complications with port removal are rare but possible.<b>Aim:</b> The study aimed to summarize venous port removal procedures performed by pediatric surgeons.<b>Material and methods:</b> The single-center, retrospective study was conducted on 360 pediatric patients treated during the years 2010-2022 in the Department of Pediatric Surgery, Traumatology, and Urology in Poznan.<b>Results:</b> The port usage time before the removal ranged from 3 days to 8 years and 3 months, with an average of 22 months. The leading cause of vascular port removal was the end of treatment (78.06%). Other less frequent reasons were the infection (13.89%) and mechanical damage of the port (3.33%). There were almost no complications connected with the procedure of vascular port removal (92.2%). If the complications occurred, they included bleeding during surgery (3%), covering the vascular catheter with bone tissue of the clavicle, causing difficulties with the catheter removal from the vein (1.4%), and connected with the previous complications-prolonged clavicle pain after surgery (1.4%) and hematoma after surgery (2%).<b>Conclusions:</b> Removing the venous port is a safe procedure with a low risk of complications. This procedure can be considered as an appropriate training procedure for young trainees. A more extended period of use of the vascular port before its removal may be associated with more difficulties during surgery.

Totally implanted chemotherapy port catheters: literature review and report of four cases

Totally implantable catheters tend to be the most popular choice because once installed they allow permanent access to a deep vein, which is gained by puncturing the port rather than a vein.

In this article, we explain four cases of chemotherapy port complications: superior vena cava (SVC) syndrome in a metastatic colorectal cancer patient who presented with bilateral mastitis, snare technique for removal of migrated catheter line, carotid artery placement of a port in a 5-year-old child that was referred to our hospital from a pediatric center and adhesive port tip in the heart that finally we left the port in situ.

In SVC syndrome, treatment should be guided by the severity of symptoms, etiology of the obstruction, prognosis of the patient and treatment goals. We propose timely removal of port-a-cath following completion of intended chemotherapeutic regimen.