Role of image-defined risk factors in predicting surgical complications of localized neuroblastoma

Liu, Tao; Lv, Zhibao; Xu, Weijue; Liu, Jiangbin; Sheng, Qingfeng

doi:10.1007/s00383-020-04731-y

Cited by 15 publications

(15 citation statements)

References 19 publications

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“…11 However, reports on surgical complications in cooperative neuroblastoma studies and metanalyses provide only overall incidences without giving more specific details for posterior mediastinal tumors, particularly concerning injury to the AKA. [12][13][14][15][16][17][18][19] Ultimately, data on impairment of neurologic function due to spinal cord ischemia after surgery for posterior mediastinal tumors in children are limited to case reports. [20][21][22][23] Even less information is available on the demonstration of AKA to guide the surgical procedure.…”

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confidence: 99%

The Relevance of Preoperative Identification of the Adamkiewicz Artery in Posterior Mediastinal Pediatric Tumors

et al. 2021

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Background Injury to the artery of Adamkiewicz (AKA) during surgery may lead to spinal cord ischemia and severe neurologic complications. Posterior mediastinal tumors may be adjacent to AKA, but data on preoperative visualization of AKA in children are rare. This study analyzed the importance of identifying the AKA preoperatively by spinal digital subtraction angiography (DSA) in children with posterior mediastinal tumors for therapeutic procedure. Methods Between 2002 and 2021, 36 children with posterior mediastinal tumors were evaluated for surgery at the authors’ clinic. In 10 children with left-sided or bilateral tumor located at vertebral levels T8 to L1, spinal DSA was performed during preoperative workup to assess AKA. The patient and tumor characteristics as well as the diagnostic and therapeutic procedures were analyzed. Results The median age of the 10 children at examination was 69 months (range, 16–217 months). Three of the children were younger than 2 years. The tumor entities were neuroblastoma, ganglioneuroblastoma, ganglioneuroma, local relapse of a hepatocellular carcinoma, and neurofibroma. The AKA was identified in all cases, and proximity to the tumor was detected in four patients, three of whom had their planned surgery changed to irradiation. No complications occurred during spinal DSA or surgery. Conclusions In posterior mediastinal pediatric tumors, spinal DSA is a safe and reliable method for preoperative visualization of the AKA. It can show proximity to the tumor and guide the local therapy, thereby avoiding critical intra- and postoperative situations.

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confidence: 99%

The Relevance of Preoperative Identification of the Adamkiewicz Artery in Posterior Mediastinal Pediatric Tumors

et al. 2021

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“…The median length of intensive care unit stay (LOSICU) was 7[0-16] days. The median length of hospital stay in the conventional ward (LOS) was 8.5 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] days. The median total length of hospital stay (TLOS=LOSICU+LOS) was 15 days.…”

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confidence: 99%

“…Long term prognosis depends on the characteristics of the tumor with ve year survival in low risk and high risk neuroblastoma varying from 90-95% to 40-50% respectively (2,5). Surgical complications after surgery depend on the localization of the tumor and are various including chyloabdomen, chylothorax, Horner syndrome, pneumothorax, injury of the renal blood vessels, injury of the inferior vena cava etc… (6,7).…”

Section: Introductionmentioning

confidence: 99%

“…Anesthetic management of neuroblastoma surgery can be challenging due the catecholamine secreting characteristics, due to the localization such as a mediastinal presentation which can cause cardiocirculatory collapse at induction of anesthesia and increased blood loss if the tumor is close to great vessels (6,7,8,9,10). This emphasizes the importance of preoperative preparation of these tumors for optimal intraoperative management.…”

Section: Introductionmentioning

confidence: 99%

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

Kumba

2021

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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.

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“…Anesthetic management of neuroblastoma surgery can be challenging due to catecholamine secreting characteristics, such as a mediastinal presentation, which can cause cardiocirculatory collapse at the induction of anesthesia and increased blood loss if the tumor is close to great vessels (6,7,8,9,10). This emphasizes the importance of preoperative preparation of these tumors for optimal intraoperative management.…”

Section: Introductionmentioning

confidence: 99%

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

Kumba

2021

Preprint

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Background: Neuroblastoma is the most common tumor in children. Anesthetic management can be challenging due to the localization and catecholamine-secreting characteristics of the tumor. We undertook a secondary analysis in a previous 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: This was a secondary analysis of children who underwent 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 broncholaryngospasm and difficult intubation. 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. 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 and optimal intraoperative management with validated means in children are necessary for a better postoperative outcome in this surgical setting.

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Role of image-defined risk factors in predicting surgical complications of localized neuroblastoma

Cited by 15 publications

References 19 publications

The Relevance of Preoperative Identification of the Adamkiewicz Artery in Posterior Mediastinal Pediatric Tumors

The Relevance of Preoperative Identification of the Adamkiewicz Artery in Posterior Mediastinal Pediatric Tumors

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

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

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