Lasso-Palomino Rubén E, Gómez Inés Elvira, Soto-Aparicio María José, Gempeler Andrés, Pombo-Jiménez Andrés, Gómez-Toro Melissa, Rojas-Robledo Valentina, Jiménez-Arévalo María Alejandra, Bastidas-Toro Karla Alejandra, Sierra Jimena, Martínez-Betancur Sofía, Ariza-Insignares Camila, Montaño-Vivas Isabella, Castro Ximena, Arias Anita V
Fundación Valle del Lili, Unidad de Cuidado Intensivo Pediátrico, Unidad Materno Infantil, Cali, Colombia.
Universidad Icesi, Facultad de Ciencias de la Salud, Departamento de Pediatría, Cali, Colombia.
Front Oncol. 2024 Dec 6;14:1491943. doi: 10.3389/fonc.2024.1491943. eCollection 2024.
Central nervous system (CNS) tumors are the second most prevalent malignant neoplasms in childhood, with surgical resection as the primary therapeutic approach. The immediate postoperative period following CNS tumor resection requires intensive care to mitigate complications associated with high morbidity and mortality.
The primary aim of this study is to comprehensively describe the postoperative complications observed in pediatric patients who underwent primary CNS tumor resection and were subsequently admitted to the pediatric intensive care unit (PICU) at Hospital Universitario Fundación Valle del Lili in Colombia.
We conducted a cross-sectional observational analysis of pediatric patients who underwent surgery for CNS tumors and were admitted to our PICU from January 2011 to December 2021. Clinical, histopathologic, and postoperative complication data were collected. A descriptive statistical analysis was performed using measures of dispersion and central tendency with a 95% confidence interval.
A total of 114 patients were included, of whom 55.3% were male. The median PICU stay was 4 days (2-7). The most common tumor type was embryonal (25.4%), followed by low-grade glioma (20.1%) and high-grade glioma (14.9%). Mechanical ventilation was required in 24.5% of patients, with a median extubation time of 3 days (2-9). In the immediate postoperative period, 6.14% of patients experienced CNS hemorrhage and 3.5% experienced intracranial hypertension. Common complications included motor deficits, facial paralysis, and sensory deficits. The mortality rate was 3.5%.
This study describes the postoperative complications, clinical challenges, and interventions observed in pediatric patients after CNS tumor resection in a resource-limited country. Our findings emphasize the importance of tailored interventions and multidisciplinary collaboration to optimize clinical outcomes. Future data comparison from centers sharing similar characteristics will play a crucial role in identifying best practices and enhancing outcomes globally.
中枢神经系统（CNS）肿瘤是儿童时期第二常见的恶性肿瘤，手术切除是主要的治疗方法。中枢神经系统肿瘤切除术后的即刻恢复期需要重症监护，以减轻与高发病率和死亡率相关的并发症。
本研究的主要目的是全面描述在哥伦比亚维利基金会大学医院接受原发性中枢神经系统肿瘤切除并随后入住儿科重症监护病房（PICU）的儿科患者中观察到的术后并发症。
我们对2011年1月至2021年12月期间接受中枢神经系统肿瘤手术并入住我们儿科重症监护病房的儿科患者进行了横断面观察分析。收集了临床、组织病理学和术后并发症数据。使用离散度和集中趋势测量方法进行描述性统计分析，置信区间为95%。
共纳入114例患者，其中55.3%为男性。儿科重症监护病房的中位住院时间为4天（2 - 7天）。最常见的肿瘤类型是胚胎性肿瘤（25.4%），其次是低级别胶质瘤（20.1%）和高级别胶质瘤（14.9%）。24.5%的患者需要机械通气，中位拔管时间为3天（2 - 9天）。在术后即刻，6.14%的患者发生中枢神经系统出血，3.5%的患者发生颅内高压。常见并发症包括运动功能障碍、面瘫和感觉功能障碍。死亡率为3.5%。
本研究描述了在一个资源有限的国家中，儿科患者中枢神经系统肿瘤切除术后观察到的术后并发症、临床挑战和干预措施。我们的研究结果强调了量身定制的干预措施和多学科合作对于优化临床结果的重要性。未来来自具有相似特征中心的数据比较将在确定最佳实践和改善全球结果方面发挥关键作用。
