Cheng Jeffrey, Liu Beiyu, Lee Hui-Jie
Pediatric Otolaryngology, Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina.
Pediatr Dermatol. 2019 Mar;36(2):207-212. doi: 10.1111/pde.13751. Epub 2019 Feb 22.
To quantify complications and rates of adverse events associated with surgical excision of hemangiomas in children using a national surgical database.
Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS NSQIP -pediatric), years 2012-2016.
Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases (ICD), 9th revision code: 228.00 and 228.01, or ICD 10 codes D18.00 and D18.01-hemangioma, any site and hemangioma, of skin and subcutaneous tissue.
A total of 1180 patients were included. The median age was 3.2 years (interquartile range [IQR] 1.2 to 6.4 years old). No occurrences of deep incisional surgical site infection, nerve injury, mortality, sepsis, septic shock, or blood stream infections were noted. In multivariate analysis, age ≤ 3 years and advanced American Society of Anesthesiologists class were significant predictors of adverse events (P = 0.035 and 0.001, respectively).
For children with infantile hemangioma who fail to respond or have an incomplete response to medical therapy, surgical resection may be a relatively safe treatment alternative. Children older than 3 years of age with hemangiomas had less surgical adverse events than younger children. Overall, however, the surgical complications rates were low and deemed relatively minor.
利用国家外科手术数据库量化儿童血管瘤手术切除相关的并发症和不良事件发生率。
2012 - 2016年美国外科医师学会（ACS）国家外科质量改进计划（ACS NSQIP -儿科）。
研究对象包括18岁以下术后诊断为国际疾病分类（ICD）第9版编码：228.00和228.01，或ICD - 10编码D18.00和D18.01的儿童——血管瘤，任何部位以及皮肤和皮下组织的血管瘤。
共纳入1180例患者。中位年龄为3.2岁（四分位间距[IQR]为1.2至6.4岁）。未发现深部切口手术部位感染、神经损伤、死亡、脓毒症、感染性休克或血流感染的发生。在多变量分析中，年龄≤3岁和美国麻醉医师协会分级较高是不良事件的显著预测因素（P分别为0.035和0.001）。
对于对药物治疗无反应或反应不完全的婴儿血管瘤患儿，手术切除可能是一种相对安全的治疗选择。3岁以上血管瘤患儿的手术不良事件比年幼患儿少。然而，总体而言，手术并发症发生率较低且被认为相对轻微。
