Aguilera-Pujabet M, Guillén G, Montferrer N, López-Fernández S, Molino J A, Lloret J
Servicio de Cirugía Pediátrica. Unidad de Cirugía Oncológica Pediátrica. Hospital Universitari Vall d'Hebron. Barcelona.
Servicio de Cirugía Pediátrica. Servicio de Anestesiología Pediátrica. Hospital Universitari Vall d'Hebron. Barcelona.
Cir Pediatr. 2016 Oct 10;29(4):142-148.
To analyze the current risk of an anesthetic event during surgical acts in pediatric patients with anterior mediastinal masses (AMM) in a tertiary oncology center, using the previously published risk factors to plan the procedure.
Retrospective study (2009-2015) of pediatric patients with AMM who underwent surgical procedures at debut. Published risk factors (symptoms, radiological findings), with special focus on the statistically significant ones, diagnosis, surgical and anesthetic procedure, special measures, and anesthetic events were recorded. Patients were classified as high or low-risk when airway or vascular compression or severe symptoms were present.
Retrospective study (2009-2015) of pediatric patients with AMM who underwent surgical procedures at debut. Published risk factors (symptoms, radiological findings), with special focus on the statistically significant ones, diagnosis, surgical and anesthetic procedure, special measures, and anesthetic events were recorded. Patients were classified as high or low-risk when airway or vascular compression or severe symptoms were present.
Preoperative evaluation of risk in AMM through clinical history and CT/MRI and surgical/anesthetic planning leads to excellent outcomes. The least aggressive procedures should be favored, but if needed, planned general anesthesia under experienced hands is safe even in risk patients.
在一家三级肿瘤中心,利用先前公布的风险因素来规划手术流程,分析患有前纵隔肿物(AMM)的儿科患者在手术过程中发生麻醉事件的当前风险。
对初次接受手术的患有AMM的儿科患者进行回顾性研究(2009 - 2015年)。记录已公布的风险因素(症状、影像学检查结果),特别关注具有统计学意义的因素、诊断、手术和麻醉流程、特殊措施以及麻醉事件。当存在气道或血管受压或严重症状时,将患者分类为高风险或低风险。
对初次接受手术的患有AMM的儿科患者进行回顾性研究(2009 - 2015年)。记录已公布的风险因素(症状、影像学检查结果),特别关注具有统计学意义的因素、诊断、手术和麻醉流程、特殊措施以及麻醉事件。当存在气道或血管受压或严重症状时,将患者分类为高风险或低风险。
通过临床病史以及CT/MRI对AMM进行术前风险评估,并进行手术/麻醉规划,可带来良好的结果。应优先选择侵入性最小的手术流程,但如有必要,在经验丰富的人员操作下进行计划性全身麻醉,即使对于高风险患者也是安全的。