Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, AL.
Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, AL.
J Surg Res. 2019 Dec;244:338-342. doi: 10.1016/j.jss.2019.06.064. Epub 2019 Jul 13.
Hepatoblastoma and Wilms tumor are the most common primary liver and kidney tumor in children, respectively, and little is documented about patient outcomes in the immediate perioperative period. The aim of this study was to analyze the short-term outcomes of pediatric patients after surgical resection for hepatoblastoma and Wilms tumor.
We queried the 2012-2016 ACS National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database for patients with hepatoblastoma who underwent liver resection and patients with Wilms tumor who underwent a partial or total nephrectomy. Patient demographics, preoperative, intraoperative, and postoperative characteristics were analyzed. Multivariate logistic regression was used to determine independent risk factors for unplanned reoperations.
There were a total of 189 patients with hepatoblastoma and 586 patients with Wilms in National Surgical Quality Improvement Program-Pediatric. The mean age of patients with hepatoblastoma was 3.1 y and 4.2 y in the Wilms group. Nine percent (n = 17) of patients underwent an unplanned reoperation after hepatectomy, and 4.1% (n = 24) of patients with Wilms experienced an unplanned reoperation. Over half of patients with hepatoblastoma (59.8%, n = 113) and 29.7% (n = 174) patients with Wilms tumor received a blood transfusion in the perioperative period. Patients in both groups demonstrated low rates of surgical site infections, but 6.3% (n = 12) of hepatoblastoma patients showed evidence of sepsis.
This study will allow providers to more effectively counsel families of the common morbidities in the associated perioperative period following surgical resection of either solid tumor type including the substantial risk of blood transfusion.
肝母细胞瘤和肾母细胞瘤分别是儿童中最常见的原发性肝和肾肿瘤，但关于其在围手术期的近期结果，文献报道较少。本研究旨在分析肝母细胞瘤和肾母细胞瘤患儿接受手术切除后的短期结局。
我们对 2012-2016 年 ACS 国家外科质量改进计划-儿科（NSQIP-P）数据库中接受肝切除术的肝母细胞瘤患者和接受部分或全部肾切除术的肾母细胞瘤患者进行了检索。分析患者的人口统计学、术前、术中及术后特征。采用多变量逻辑回归分析确定计划外再次手术的独立危险因素。
共有 189 例肝母细胞瘤患者和 586 例肾母细胞瘤患者纳入 NSQIP-P。肝母细胞瘤患者的平均年龄为 3.1 岁，肾母细胞瘤患者的平均年龄为 4.2 岁。肝切除术后有 9%（n=17）的患者行计划外再次手术，肾母细胞瘤患者中有 4.1%（n=24）行计划外再次手术。超过一半的肝母细胞瘤患者（59.8%，n=113）和 29.7%（n=174）的肾母细胞瘤患者在围手术期接受了输血。两组患者的手术部位感染发生率均较低，但有 6.3%（n=12）的肝母细胞瘤患者出现败血症的证据。
本研究将使医疗服务提供者能够更有效地向接受这两种实体瘤类型手术切除的患儿家属提供相关围手术期常见并发症的信息，包括大量输血的风险。
