Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Departamento de Cirurgia Pediátrica, Recife, PE, Brazil; Faculdade Pernambucana de Saúde, Recife, PE, Brazil.
Faculdade Pernambucana de Saúde, Recife, PE, Brazil; Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Departamento de Anestesiologia, Recife, PE, Brazil.
J Pediatr (Rio J). 2019 Jan-Feb;95(1):54-60. doi: 10.1016/j.jped.2017.10.012. Epub 2017 Dec 29.
To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents.
A retrospective cross-sectional study was conducted with a population consisting of children and adolescents with abdominal non-Hodgkin's lymphoma diagnosed between September 1994 and December 2012. The sample comprised of 100 patients who underwent 113 diagnostic procedures, including urgent surgery (n=21), elective surgery (n=36), and non-surgical diagnosis (n=56).
The most frequent procedures were laparotomy (46.9%) and ultrasound-guided core biopsy (25.6%). The rate of diagnostic success was 95.2% for urgent surgeries; 100% for elective surgeries and 82.1% for non-surgical procedures (p<0.05). The rates of complication during the three diagnosis procedures considered were significant (p<0.001; 95.2% of the urgent surgeries, 83.8% of the elective surgeries, and 10.7% of the non-surgical procedures). The length of time before resuming a full diet and starting chemotherapy was significantly reduced for patients who underwent non-surgical procedures when compared with the other procedures (p<0.001).
Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease.
描述儿童和青少年腹部非霍奇金淋巴瘤诊断程序的成功率和并发症。
本研究采用回顾性的病例交叉研究,对 1994 年 9 月至 2012 年 12 月期间被诊断为腹部非霍奇金淋巴瘤的儿童和青少年进行研究。该研究的样本由 100 名患者组成,他们接受了 113 次诊断程序,包括紧急手术(n=21)、择期手术(n=36)和非手术诊断(n=56)。
最常见的诊断程序为剖腹探查术(46.9%)和超声引导下核心活检(25.6%)。紧急手术的诊断成功率为 95.2%;择期手术为 100%;非手术诊断为 82.1%(p<0.05)。三种诊断程序的并发症发生率均有显著差异(p<0.001;紧急手术为 95.2%,择期手术为 83.8%,非手术诊断为 10.7%)。与其他程序相比,接受非手术诊断的患者在恢复全饮食和开始化疗的时间明显缩短(p<0.001)。
对于儿童腹部非霍奇金淋巴瘤的诊断,非手术程序是一种有效的选择,其发病率低,能更早地恢复全饮食和开始化疗。此外,对于广泛疾病的患者,也应考虑采用非手术程序获取肿瘤样本。