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Outcome analysis of surgical complications in pediatric solid tumors: a retrospective clinical study
Arihant Jain1, Nitin James Peters2, Ram Samujh1
1Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Postoperative complications in pediatric solid tumor surgery impact outcomes. Severe complications, graded by Clavien-Dindo, are linked to longer hospital stays and reduced survival probability.
Area of Science:
- Pediatric Surgical Oncology
- Clinical Outcomes Research
- Cancer Patient Management
Background:
- Postoperative complications in pediatric cancer patients can delay adjuvant therapy and affect quality of life.
- Evaluating the severity and impact of these complications is crucial for optimizing patient care.
- The Clavien-Dindo classification system is a standard for grading surgical complications.
Purpose of the Study:
- To assess the severity and effects of postoperative complications in children undergoing surgery for solid tumors.
- To validate the utility of the Clavien-Dindo classification system in this specific pediatric population.
- To identify risk factors associated with severe complications.
Main Methods:
- Retrospective analysis of 188 pediatric patients with solid tumors over a 5-year period.
- Complications were classified using the Clavien-Dindo system.
- Risk factors and implications for patient care were analyzed.
Main Results:
- The majority of complications (83.5%) were low-grade (1 or 2).
- Higher intraoperative blood loss, adjacent organ infiltration, and longer operative times correlated with more severe complications.
- Severe complications (grades 3-4) were associated with longer hospital stays and a significantly lower survival probability.
Conclusions:
- Postoperative complications significantly affect short-term surgical outcomes in pediatric cancer patients.
- Severe complications may negatively impact long-term oncological outcomes.
- The Clavien-Dindo classification system is a valuable tool for grading postoperative complications in pediatric surgical oncology.
Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
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 Of Evidence:
Level III.
