Jain Arihant, Peters Nitin James, Samujh Ram, Trehan Amita, Malik Muneer Abas, Madan Renu, Dogra Shivani, Solanki Shailesh, Singh Jitender, Kanojia Ravi P, Bansal Deepak, Jain Richa, Bawa Monika, Kapoor Rakesh, Yaddanapudi Sandhya, Mahajan J K
Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pediatrics, Pediatric Haematology, and Oncology Division, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Pediatr Surg Int. 2025 Jul 1;41(1):201. doi: 10.1007/s00383-025-06069-9.
Postoperative complications can significantly impact patient outcomes and quality of life, particularly in children with solid tumors. These complications may delay the commencement of adjuvant therapy. This study aimed to evaluate the severity and effects of these complications and to validate the Clavien-Dindo classification system in pediatric patients following surgery for solid tumors.
A retrospective analysis was conducted on postoperative complications in children with solid tumors at a tertiary care teaching hospital over 5 years. Patient demographics and tumor types were recorded, and complications were categorized using the Clavien-Dindo classification. The study identified key risk factors for complications and their implications for patient care.
We included 188 patients, out of which the majority (n = 157; 83.5%) had low-grade (grade 1 or 2) postoperative complications. Higher intraoperative blood loss (p < 0.001), adjacent organ infiltration, and longer operative times were associated with more severe grade of complications. Patients with higher-grade complications also had longer hospital stays (Kendall's Tau coefficient of 0.48). Among the 26 patients with tumor recurrence, 30% had experienced severe complications (grades 3 and 4). The Kaplan‒Meier curve and log-rank test (p < 0.001) showed that severe complications are linked to a lower survival probability.
The analysis of complications showed a significant effect on short-term surgical outcomes, and severe complications may also impact oncological outcomes. The Clavien-Dindo classification is a useful tool for grading postoperative complications in pediatric surgical oncology.
Level III.
术后并发症会显著影响患者的治疗结果和生活质量，尤其是对于实体瘤患儿。这些并发症可能会延迟辅助治疗的开始。本研究旨在评估这些并发症的严重程度和影响，并验证Clavien-Dindo分类系统在实体瘤患儿手术后的有效性。
对一家三级护理教学医院5年来实体瘤患儿的术后并发症进行回顾性分析。记录患者的人口统计学信息和肿瘤类型，并使用Clavien-Dindo分类对并发症进行分类。该研究确定了并发症的关键风险因素及其对患者护理的影响。
我们纳入了188例患者，其中大多数（n = 157；83.5%）有低级别（1级或2级）术后并发症。术中失血较多（p < 0.001）、邻近器官浸润和手术时间较长与更严重级别的并发症相关。并发症级别较高的患者住院时间也更长（肯德尔tau系数为0.48）。在26例肿瘤复发患者中，30%曾经历严重并发症（3级和4级）。Kaplan-Meier曲线和对数秩检验（p < 0.001）表明，严重并发症与较低的生存概率相关。
并发症分析显示对短期手术结果有显著影响，严重并发症也可能影响肿瘤学结果。Clavien-Dindo分类是小儿外科肿瘤学中对术后并发症进行分级的有用工具。
三级。
