Real-World Chemoport Outcomes in Pediatric Oncology in a Resource-Limited Setting: A Retrospective Analysis With Pragmatic Implications.
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INTRODUCTION: Reliable long-term venous access is crucial for pediatric oncology, particularly in resource-limited settings where peripheral intravenous access often proves inadequate. Totally implantable venous access devices or chemoports, provide a durable and safe alternative. However, literature from newly established cancer centers in low- and middle-income countries remains sparse. This study aims to evaluate the clinical outcomes, complication rates, and practical challenges associated with pediatric chemoport use in such a setting. METHODS: A retrospective observational study was conducted at a government-supported tertiary cancer center in North India. Pediatric patients (≤15 years) who underwent chemoport insertion between January 2019 and December 2023 were included. Patient demographics, diagnosis, insertion technique, port site, duration, complications, and microbiological culture data were analyzed. Infection and removal rates were expressed per 1000 catheter-days. RESULTS: A total of 127 chemoports were inserted in 121 children, with a median age of 16.2 months and a male-to-female ratio of 3.5:1. The right internal jugular vein was used in 93% of cases. The mean port indwelling time was 290.8 ± 215.2 days, totaling 35,190 catheter-days. No intraoperative complications were observed. Infections occurred in 32 patients (26.4%), with an infection rate of 0.91 per 1000 catheter-days. Early infections (≤30 days) occurred in 2.3% of patients. Unplanned complication-related port removal was required in 16 cases (13.2%), most commonly due to infection. Microbiological cultures predominantly isolated Staphylococcus species and gram-negative bacilli. CONCLUSION: Chemoports are safe and effective for pediatric oncology in LMICs when standard protocols are followed. Complication rates and port longevity were comparable to international standards. Structured training, infection control measures, and policy-level support are essential for broader adoption and improved outcomes in resource-constrained environments.