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小儿腹部实体瘤手术术后早期并发症的 Clavian-Dindo 分类。

Early postoperative complications in pediatric abdominal solid tumor surgery according to Clavian-Dindo classification.

机构信息

Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey.

Department of Pediatric Radiology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey.

出版信息

Pediatr Surg Int. 2022 Sep;38(9):1303-1310. doi: 10.1007/s00383-022-05163-6. Epub 2022 Jul 12.

Abstract

PURPOSE

Postoperative period after abdominal solid tumor surgery is critical regarding complications. This study aimed to detect incidence and treatment of complications.

METHODS

Single center retrospective study including years 2010-2019 for early postoperative complications were documented and graded according to Clavian-Dindo classification.

RESULTS

The overall complication rate was 10% and they were chylous leak (n = 8, 2%), collection in surgical field (n = 8, 2%), acute renal failure (n = 7, 1.7%), hemorrhage (n = 5, 1.3%), intestinal obstruction (n = 4, 1%), surgical site infection (n = 3, 0.7%), thromboembolism (n = 3, 0.7%) and peripheric neuronal event (n = 2, 0.5%). Distribution of complications according to Clavian-Dindo classification was as follows: 2 grade I, 23 grade II, 9 grade IIIb, 5 grade IVa and 1 grade V. While age and percentage of benign or malignant disease were not different in groups with or without complications (p = 0.11, p = 0.24), males had more complications than female patients (p = 0.008). Having more than one surgery aiming tumor resection was associated with increased postoperative complications (p = 0.002). Incidence of complications were highest after extragonadal germ cell tumor (35%) and hepatic tumors (29%).

CONCLUSIONS

Postoperative complications of abdominal tumor surgery are diverse in children. They are related with prolonged hospital stay and need for medical or surgical interventions. Number of surgeries, organ of origin and tumor type have an influence on risk of complications.

摘要

目的

腹部实体瘤手术后的围手术期是并发症的关键时期。本研究旨在检测并发症的发生率和治疗方法。

方法

单中心回顾性研究,纳入 2010 年至 2019 年的早期术后并发症,根据 Clavian-Dindo 分类进行记录和分级。

结果

总的并发症发生率为 10%,包括乳糜漏(n=8,2%)、手术部位积液(n=8,2%)、急性肾功能衰竭(n=7,1.7%)、出血(n=5,1.3%)、肠梗阻(n=4,1%)、手术部位感染(n=3,0.7%)、血栓栓塞(n=3,0.7%)和周围神经事件(n=2,0.5%)。根据 Clavian-Dindo 分类,并发症的分布如下:2 级 I,23 级 II,9 级 IIIb,5 级 IVa 和 1 级 V。然而,有并发症和无并发症组之间的年龄和良性或恶性疾病的百分比没有差异(p=0.11,p=0.24),男性比女性患者有更多的并发症(p=0.008)。有不止一次手术以切除肿瘤与术后并发症增加有关(p=0.002)。性腺外生殖细胞肿瘤(35%)和肝脏肿瘤(29%)的术后并发症发生率最高。

结论

儿童腹部肿瘤手术后的并发症多种多样。它们与住院时间延长和需要医疗或手术干预有关。手术次数、起源器官和肿瘤类型对并发症的风险有影响。

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