A. M. Waters1, M. Mathis1, E. A. Beierle1, R. T. Russell1 1University Of Alabama at Birmingham,Pediatric Surgery,Birmingham, Alabama, USA
Introduction: Hepatoblastoma and Wilms’ tumor is the most common primary liver and kidney tumor in children, respectively. Multiple prospective cohort studies have been performed to describe the long-term outcomes of children with solid tumors. However, little is documented about outcomes in the perioperative period. The aim of this study is to analyze the short-term outcomes of pediatric patients after surgical resection for hepatoblastoma or Wilms’ tumor.
Methods: We queried the 2012 to 2016 ACS National Surgical Quality Improvement Program-Pediatric (NSQIP-P) Participant Use File for patients with hepatoblastoma who underwent liver resection and patients with Wilms’ tumor who underwent a partial or total nephrectomy. Patient demographics, preoperative, intraoperative, and postoperative characteristics were analyzed. Multivariate logistic regression was used to determine independent risk factors for unplanned reoperations and readmissions.
Results: A total of 189 patients with hepatoblastoma and 586 patients with Wilms’ tumor met inclusion criteria. Demographics were as expected with mean age of 4.2 years of patients with hepatoblastoma and 3.1 years in the Wilms’ group. 79.9% of liver resections were performed open and 9% (n=17) of patients underwent an unplanned reoperation. Furthermore, 78.7% of nephrectomies were completed open and 4.1% (n=24) of patients experienced an unplanned reoperation. Over half of patients with hepatoblastoma (59.8%, n=113) and 29.7% (n=174) patients with Wilms’ tumor received a blood transfusion intraoperatively or in the perioperative period. The mean volume of blood transfused after liver resection was 40.8 ml/kg (SD=37.9) and 24.5 ml/kg (SD=28.8) after nephrectomy. Patients in both groups demonstrated low rates of surgical site infections but 6.3% (n=12) of hepatoblastoma patients showed evidence of sepsis (Table 1). Multivariate analysis demonstrated no significant risk factors for readmission or reoperation.
Conclusion: This study will allow providers to more effectively counsel families of the common morbidities in the associated perioperative period following surgical resection of either solid tumor type including the high risk of blood transfusion
