Background Implanted vascular access devices play an essential role in the management of pediatric patients. The objectives of this study were to assess our experience with port-a-cath insertion in pediatric patients, report its complications, and compare open versus percutaneous approaches. Methods We performed a retrospective cohort study, including 568 patients who underwent port-a-cath insertion between 2013 and 2019 in our center. We grouped the patients according to the technique of insertion into two groups: group 1 (n = 168) included patients who had the open approach and group 2 (n = 404) included patients who had the percutaneous technique. (p < 0.001). Results Patients in group 1 were younger (4.10 ± 3.45 years) compared to patients in group 2 (5.47 ± 3.85 years). The main indications of insertion were hematological malignancy 57.74% (n = 328), solid organ malignancy 25.18% (n = 143), pure hematological diseases 5.46% (n = 31), metabolic diseases 2.64% (n = 15), and others for poor vascular access 8.8% (n = 50). The most common site for insertion in group 1 was the left external jugular (n = 136; 82.98%) and the left subclavian in group 2 (n = 203; 50.25%). Two hundred and two patients had a central line before catheter insertion (36.6%). Complications during insertion were comparable between both groups (p = 0.427). The catheter got stuck in 6 patients; all required additional incision and two needed venotomy. The most common reason to remove the catheter was the completion of the treatment (63.69% and 61.14%, in groups 1 and 2, respectively). The duration of the catheter was comparable between the two groups (13.14 ± 14.76 vs. 14.44 ± 14.04 months in group 1 vs.2; p = 0.327). Conclusions Open and percutaneous port-a-cath insertions are safe in children with chronic diseases. Port-a-cath improved patients’ management, and complications are infrequent. The most common complications are infection and catheter malfunction, which can be managed without catheter removal in some patients.

Introduction: Anorectal malformations (ARM) constitute one of the frequent congenital anomalies which are encountered in pediatric surgery in 1 in 5000 births. The defect affects the normal positioning of the anus, and a corrective surgical procedure is required for repositioning. Rectovestibular fistula is the most common form of ARM that is found in female infants. Posterior sagittal anorectoplasty (PSARP) without colostomy (single-stage) and Posterior sagittal anorectoplasty with colostomy (three-stages) has often been compared as the most feasible interventions to treat both rectovestibular and rectoperineal fistulae. The objective of this study was to assess the result of posterior anorectoplasty with or without diverting colostomy in patients with rectoperineal or rectovestibular fistulae. Methodology: A retrospective cohort study was undertaken to examine the post-operative outcomes of single-stage and three-stages PSARP on infants with rectovestibular and rectoperineal fistulae in Riyadh and Jeddah regions of Saudi Arabia. After ethical approvals from King Abdullah International Medical Research Centre, the study reviewed patient files from National Guard hospitals from the two regions. Results: Out of the 50 patients studied, 80% were females, while 20% were males. The most typical type of fistula was rectovestibular, which accounted for 54%, while rectoperineal accounted for 46%. PSARP without colostomy (single-stage) was the most common intervention. Major complications reported after the operations were constipation (44%), soiling (10%), wound infection (6%) and dehiscence (6%). Conclusion: The one-stage PSARP without colostomy has been identified as the feasible, safe, cost-effective surgical procedure to be used on ARM infants.