Neuroblastoma in Children: Intraoperative Goal Directed Therapy, Intraoperative And Postoperative Outcomes

Abstract

Background Neuroblastoma is the most common tumor in children. Anesthetic management can be challenging due to the localization, catecholamine-secreting characteristic of the tumor. We undertook a secondary analysis in a previously study to describe patients who underwent neuroblastoma resection. Objective To describe intraoperative and postoperative outcomes in patients who underwent neuroblastoma resection and to propose optimal intraoperative management for postoperative outcome improvement. Methods Secondary analysis of children who had neuroblastoma resection in the initial retrospective study. Results There were 16 patients with a mean age of 39.3±22.1 months. Seven (43.8%) patients presented with intraoperative or postoperative complications. One (6.3%) patient had intraoperative broncho-laryngospasm and difficult intubation respectively. Two (12.5%) patients had intraoperative hemorrhagic shock. One patient (6.3%) had postoperative renal failure. Two patients (12.5%) had postoperative respiratory failure and 3 (18.8%) patients had postoperative cardiocirculatory failure. One (6.3%) had postoperative pulmonary sepsis and septicemia respectively. Thirteen (81.3%) patients were intraoperatively transfused. There was no in-hospital mortality. Conclusion Neuroblastoma surgery can be a challenging situation where cardiovascular instability, high blood loss and transfusion requirements can be encountered. Consequently, preoperative preparation, intraoperative optimal management with validated means in children are necessary for a better postoperative outcome in this surgical setting.

Postoperative Outcomes in Exploratory Laparotomy and Intestinal Resection in Children: A Secondary Descriptive Observational Analysis

“…This protocol will clarify the impact of this validated tool on postoperative outcomes in pediatric surgical patients (16,17). Similar conclusions have been drawn in other major pediatric surgical settings where goal-directed therapies need to be developed in research protocols to determine their impact on postoperative outcomes (11)(12)(13)(14)(15).…”

“…The results of this secondary analysis highlight that morbidity in terms of postoperative organ dysfunction and infection in patients who underwent exploratory laparotomy and intestinal resection was high. Similar analyses have been conducted in other surgical pediatric settings (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). How could these outcomes be improved?…”

Postoperative Outcomes in Exploratory Laparotomy and Intestinal Resection in Children: A Secondary Descriptive Observational Analysis

“…The results of this secondary analysis highlight that morbidity in terms of postoperative organ dysfunction and infection in patients who underwent exploratory laparotomy and intestinal resection was high. Similar analyses have been conducted in other surgical pediatric settings [5]- [15]. How could these outcomes be improved?…”

“…This protocol will clarify the impact of this validated tool on postoperative outcome in pediatric surgical patients[16] [17]. Similar conclusions have been drawn in other major pediatric surgical settings where goal-directed therapies need to be developed in research protocols to determine their impact on postoperative outcomes[11] [12] [13] [14][15].…”

Anesthesia Management For Pediatric Liver Transplantation: Narrative Review

“…PICU stay, morbidity, and mortality can be reduced thanks to careful fluid management. When necessary, vasoactive drugs and adequate fluid therapy to protect the brain, heart, and kidney may provide better hemodynamic stabilization, CO, and perfusion [30][31][32]. In our clinic, fluid management is performed under the guidance of PiCCO.…”