Peri-operative Safety and Complications of Central Venous Access Device in Paediatric-Haemato-Oncology Patients: A Single-Centre Experience of 180 Procedures with Special Focus on Chemoport Insertion.

Abstract

Reliable long-term central venous access is a cornerstone in the management of paediatric haematology and oncology patients. The use of chemoport in paediatric populations remains limited, primarily due to concerns regarding peri-procedural risks and associated complications. We aim to present our experience of central venous access device (CVAD) in paediatric-haemato-oncology patients with special focus on chemoport insertion, with respect to standardisation of technique, peri-procedural safety, and complications. The paediatric haematology and oncology patients who underwent CVAD insertion between June 2019 and June 2025 were included in the study. The data were retrospectively reviewed from a prospectively maintained department database. The variables included patient demographics, indication, site, route of insertion, technique used, and peri-operative complications. A total of 180 CVAD insertions were performed in paediatric patients between June 2019 and June 2025. Among them, 155 (86.1%) had haematolymphoid malignancies, and 25 (13.9%) had solid tumours. The youngest patient was 4 months old and the eldest was 18 years. Of the 180 CVAD insertions, 140 were chemoport insertions, 29 received Hickman lines, and 11 were subclavian lines. Among the chemoport recipients, six patients (4.3%) had complications, which included: one had a guidewire-associated right atrial rupture, which was managed by emergency thoracotomy; two developed pneumothorax requiring intercostal drainage, and three had minor complications such as port-site erythema and post-procedural fever, managed conservatively. All patients recovered uneventfully and commenced treatment without delay. Totally implantable devices such as chemoports are safe and reliable for paediatric patients with haematological and solid malignancies. Although associated with a learning curve and potential procedural risks, these can be minimised through standardised techniques, protocol-driven care, and continuous personnel training.