Emrah Şenel, Melike Kaya Bahcecitapar, Gülsen Keskin, Devrim Tanıl Kurt, Ervin Mambet, Mine Akın, Sibel Saydam, Sengül Özmert

Çocuk Hastalarda Tünelli Santral Venöz Kateterlerin Perkütan ve Cerrahi Yerleştirilmesindeki Komplikasyonlar

Amaç: Kalıcı tünelli kateterlerin ultrasonografi (USG) rehberliğinde perkütan olarak yerleştirilme- si, pratik, güvenli ve yaygın kullanılan bir girişimdir. Çalışmamızın amacı; pediyatrik hemato- onkoloji hastalarında perkütan veya açık cerrahi yöntem ile yerleştirilen kalıcı tünelli kateterlere bağlı komplikasyonları incelemek ve karşılaştırmaktır. Yöntem: Kliniğimizde, 2013-2015 yılları arasında, kemik iliği nakli için Hickman tipi tünelli santral venöz kateter yerleştirilen, ASA 3-4 grubundan 101 pediyatrik hastanın tıbbi kayıtları geriye dönük olarak incelendi. Hastaların demografik verileri, kateter yerleştirme yeri, boyutu, girişim sırasında ve sonrasında karşılaşılan komplikasyonlar ve kateter çıkarılma nedenleri kaydedildi. Bulgular: Yüz bir tünelli santral venöz kateterin, 54 hastada USG rehberliğinde perkütan olarak, 47 hastada ise açık teknik kullanılarak yerleştirildiği tespit edildi. Her iki gruptaki hastalar yaş, boy, kilo, takılan kateter boyutu, kateterizasyon süresi ve çıkarılma nedenleri açısından benzerdi. Kateter ile ilişkili intraoperatif ve postoperatif teknik ve enfektif komplikasyonlar açısından perkü- tan ve cerrahi gruplar arasında fark bulunmadı. Sonuç: Pediyatrik hemato-onkoloji hastalarındaki kalıcı tünelli kateter girişimlerinin, perkütan teknik ve açık teknik ile uygulanması arasında intraoperatif ve postoperatif komplikasyonlar açı- sından fark bulunmadı. Her iki teknik de düşük komplikasyon oranları ile kullanılabilir, perkütan teknik daha az invazif olduğu için tercih edilebilir

Complications in Percutaneous and Surgical Insertion of Tunneled Central Venous Catheters for Pediatric Patients

Objective: Percutaneous insertion of permanent tunneled catheters, accompanied by ultrasonography (USG) guidance, has established itself as practical, safe, and widely used procedure. The purpose of our study; To examine and compare the complications associated with permanent tunneled catheters placed by percutaneous or open surgical method in pediatric hemato-oncology patients. Methods: Medical records of 101 pediatric patients from the ASA 3-4 group who were placed in a Hickman-type tunneled central venous catheter for bone marrow transplantation between 2013 and 2015 in our clinic were retrospectively reviewed. Demographic data of the patients, catheter insertion location, size, complications encountered during and after the intervention, and reasons for catheter removal were recorded. Results: One hundred and one tunneled central venous catheters were placed percutaneously under USG guidance in 54 patients, and using open technique in 47 patients. Patients in both groups were similar in terms of age, height, weight, size of the inserted catheter, duration of catheterization, and reasons for removal. No difference was found between percutaneous and surgical groups in terms of intraoperative and postoperative to technique, and infective complications related to catheter. Conclusion: In pediatric hemato-oncology patients, there is no difference in terms of intraoperative, and postoperative complications between percutaneous technique and open technique for permanent tunneled central catheter insertion. Both techniques can be used with low complication rates, and the percutaneous technique may be preferred because it is less invasive

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