Hamilton Emma C, Curtin Thomas, Slack Rebecca S, Ge Christine, Slade Austen D, Hayes-Jordan Andrea, Lally Kevin P, Austin Mary T
*Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston Departments of †Surgical Oncology ‡Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
J Pediatr Hematol Oncol. 2017 Oct;39(7):e342-e348. doi: 10.1097/MPH.0000000000000902.
The purpose of our study was to evaluate surgical enteric access in pediatric cancer patients to determine factors associated with postoperative complications. We performed a single-institution retrospective review of all patients below 21 years old with a primary cancer diagnosis who underwent surgical procedures for enteral access between 2004 and 2014. Multivariate logistic regression was performed to determine independent predictors of postoperative complications. During the study period, 122 patients had surgically placed feeding tubes, of whom 58% developed ≥1 complication(s) and 16% experienced a major complication. No single factor was significantly associated with developing any complication or major complication. Several trends were noted including increased complications associated with jejunostomy tubes, percutaneous endoscopic gastrostomy tubes, and abdominal radiation. Surgically placed enteric access in pediatric and adolescent cancer patients is associated with an extremely high complication rate emphasizing the importance of careful evaluation of these patients before embarking on surgical feeding access. Future work should evaluate mechanisms to decrease complications and/or explore alternative methods to provide supplemental nutrition in children and adolescents with cancer.
我们研究的目的是评估儿科癌症患者的手术肠道造口术，以确定与术后并发症相关的因素。我们对2004年至2014年间所有21岁以下、患有原发性癌症诊断且接受了肠道造口术手术的患者进行了单机构回顾性研究。进行多因素逻辑回归以确定术后并发症的独立预测因素。在研究期间，122例患者接受了手术放置喂食管，其中58%发生了≥1种并发症，16%经历了严重并发症。没有单一因素与发生任何并发症或严重并发症显著相关。注意到了几个趋势，包括与空肠造口管、经皮内镜下胃造口管和腹部放疗相关的并发症增加。儿科和青少年癌症患者的手术肠道造口术与极高的并发症发生率相关，强调了在进行手术喂养造口之前对这些患者进行仔细评估的重要性。未来的工作应评估降低并发症的机制和/或探索为患有癌症的儿童和青少年提供补充营养的替代方法。
