Successful use of indwelling tunneled catheters for the management of effusions in children with advanced cancer

• Published in: Pediatric blood & cancer Vol. 61; no. 6; pp. 1007 - 1012
• Main Authors: den Hollander, Barbara S., Connolly, Bairbre L., Sung, Lillian, Rapoport, Adam, Zwaan, C.M., Grant, Ronald M., Parra, Dimitri, Temple, Michael J.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.06.2014; Wiley Subscription Services, Inc
• Subjects: Adolescent; ascites; Ascites - etiology; Ascites - surgery; Ascites - therapy; Catheter-Related Infections - etiology; catheters; Catheters, Indwelling - adverse effects; Child; Child, Preschool; Drainage - instrumentation; Drainage - methods; Female; Hematology; Home Care Services; Humans; indwelling; Male; malignant; Oncology; Pain - etiology; Palliative Care; Paracentesis; Patient Acceptance of Health Care; pediatric oncology; Pediatrics; pleural effusion; Pleural Effusion, Malignant - etiology; Pleural Effusion, Malignant - surgery; Pleural Effusion, Malignant - therapy; Pleurodesis; Quality of Life; Recurrence; Retrospective Studies; Sarcoma - complications; ascites; pediatric oncology; catheters; pleural effusion; indwelling; malignant
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.24902

Background Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer. Methods Children with MPE/MA who underwent ITC insertion (2007–2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed. Results PleurX® ITCs (n = 12) were inserted in eight patients (5–18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n = 1), late site infection (n = 1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ. Conclusions ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home. Pediatr Blood Cancer 2014;61:1007–1012. © 2013 Wiley Periodicals, Inc.