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Study on the relationship between obesity and complications of Pediatric Epilepsy surgery
Lei Shen1, Mengyang Wang1, Jingwei Zhao1
1Department of Neurosurgery, Zhongnan Hospital, Wuhan University, 430071, Wuhan, Hubei, China.
Insights
Obese children undergoing epilepsy surgery experienced increased intraoperative blood loss. Early weight management is recommended for pediatric epilepsy patients to improve surgical outcomes and reduce complications.
Area of Science:
- Pediatric Surgery
- Neurology
- Obesity Research
Background:
- Obesity is linked to adverse surgical outcomes in adults.
- The impact of obesity on pediatric epilepsy surgery outcomes remains under-explored.
Purpose of the Study:
- To investigate the relationship between obesity and complications in pediatric epilepsy surgery.
- To assess the effect of obesity on the outcomes of pediatric epilepsy surgery.
- To inform weight management strategies for children with epilepsy.
Main Methods:
- Retrospective analysis of 36 children undergoing epilepsy surgery at a single center.
- Obesity assessment using age-adjusted Body Mass Index (BMI) percentiles.
- Comparison of intraoperative blood loss, operation time, and postoperative fever between obese and nonobese groups.
Main Results:
- Obesity was associated with significantly higher intraoperative blood loss (p=0.04) in pediatric epilepsy surgery.
- No significant correlation was found between obesity and operation time (p=0.21).
- Obese children showed a trend towards higher postoperative fever risk (56.3% vs. 55.0%), but this was not statistically significant (p=0.61).
- Long-term seizure control (Engel grades) did not differ between obese and nonobese groups (p=0.682).
Conclusions:
- Obese children with epilepsy experience greater intraoperative blood loss during surgery.
- Early weight management is crucial for children with epilepsy to potentially mitigate surgical complications.
- Further research is needed to fully elucidate the long-term effects of obesity on pediatric epilepsy surgery outcomes.
Objective:
Studies have shown that obesity has a significant impact on poor surgical outcomes. However, the relationship between obesity and pediatric epilepsy surgery has not been reported. This study aimed to explore the relationship between obesity and complications of pediatric epilepsy surgery and the effect of obesity on the outcome of pediatric epilepsy surgery, and to provide a reference for weight management of children with epilepsy.
Methods:
A single-center retrospective analysis of complications in children undergoing epilepsy surgery was conducted. Body mass index (BMI) percentiles were adjusted by age and used as a criterion for assessing obesity in children. According to the adjusted BMI value, the children were divided into the obese group (n = 16) and nonobese group (n = 20). The intraoperative blood loss, operation time, and postoperative fever were compared between the two groups.
Results:
A total of 36 children were included in the study, including 20 girls and 16 boys. The mean age of the children was 8.0 years old, ranging from 0.8 to 16.9 years old. The mean BMI was 18.1 kg/m2, ranging from 12.4 kg/m2 to 28.3 kg/m2. Sixteen of them were overweight or obese (44.4%). Obesity was associated with higher intraoperative blood loss in children with epilepsy (p = 0.04), and there was no correlation between obesity and operation time (p = 0.21). Obese children had a greater risk of postoperative fever (56.3%) than nonobese children (55.0%), but this was statistically nonsignificant (p = 0.61). The long-term follow-up outcomes showed that 23 patients (63.9%) were seizure-free (Engel grade I), 6 patients (16.7%) had Engel grade II, and 7 patients (19.4%) had Engel grade III. There was no difference in long-term seizure control outcomes between obese and nonobese groups (p = 0.682). There were no permanent neurological complications after surgery.
Conclusion:
Compared with nonobese children with epilepsy, obese children with epilepsy had a higher intraoperative blood loss. It is necessary to conduct early weight management of children with epilepsy as long as possible.
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