Abstract:
BACKGROUND: Complications of totally implanted venous access ports are well documented. A concerning mechanical complication we have encountered is posterior penetration of plastic ports with the access needle. The purpose of this study is to investigate the burden of posterior penetrations.
METHODS: We performed a retrospective review of all ports placed between November 2007 and December 2011 at a single institution.
RESULTS: There were 247 children who received a port. 117 children (47%) received a port with a plastic posterior wall, 95 children (38%) received a port with a metal posterior wall, and 35 children (14%) had ports that were unable to be identified as plastic or metal. Posterior port penetrations occurred 8 times (3.2% overall, 6.8% of plastic ports). All perforations occurred in plastic ports of a single brand and product code. Average time from port insertion to penetration was 11.2±21.3months (range 0.3 to 63.4months). Other complications included catheter malfunction (14), infection (9), pain (2), inability to draw/aspirate (4), leak (3), port migration (2), and malfunctioning not otherwise specified (15).
CONCLUSIONS: There is an unacceptably high risk of needle penetration of the posterior wall of plastic ports. We recommend utilizing ports with metal backing to avoid this complication.
Reference:
Sharp, N.E., Knott, E.M., Thomas, P., Rivard, D.C. and St Peter, S.D. (2014) Burden of complications from needle penetration of plastic ports in children. Journal of Pediatric Surgery. 49(5), p.763-5.