Surgical complications related to hematopoietic stem cell transplantation

Surgical complications in recipients of hematopoietic stem cell transplantation (HSCT) are common. However, this issue is infrequently reported in the literature.

The records of 165 patients who underwent hematopoietic stem cell transplantation at King Hussein Cancer Center between January 2007 and December 2008 were retrospectively reviewed. All surgical complications were included and were classified into gastrointestinal (GI), catheter-related, ear, nose and throat (ENT), peri anal, musculoskeletal, neurological and urological complications.

There were 279 surgical complications in the studied patients. Gastrointestinal (n = 122) and catheter-related (n = 78) complications were the most frequent. The frequency and the percentage of patients needing surgical intervention for the 5 most common complications were as follows: Gastrointestinal (n = 122, 4.5% needed surgical intervention), catheter-related (n = 78, 46.2%), ear, nose and throat (n = 31, 9.7%), perianal disease (n = 21, 19%) and urinary complications (n = 17, 5.9%). Surgical consultation was sought for 116 surgical complications. Surgical interventions were necessary for 55 patients. All the patients who underwent surgery did not have an intervention-related mortality except for one patient who died from surgical intervention post-gastrointestinal complication.

The majority of surgical complications after HSCT do not require surgical intervention. However, these conditions may overlap with the more common reasons for surgical consultation and must be identifiable by the surgeon. Extra vigilance is necessary when dealing with both GI and catheter-related complications as they are the most frequent. The early involvement of surgeons and proper timing of surgical management may circumvent detrimental outcomes.