Appendectomy in pediatric patients with synchronous oncologic diagnosis is safe: an analysis using the national surgical quality improvement project, pediatric
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In brief
In brief
This NSQIP study of 28,219 pediatric appendectomy patients found that children actively receiving cancer treatment (n=95) had no increased risk of postoperative wound complications compared to non-cancer patients, despite higher steroid use and lower white blood cell counts. The findings support proceeding with appendectomy in pediatric oncology patients when clinically indicated.
Written by the GCMD Library team from the article.
Abstract
Background
Optimal treatment of children who develop appendicitis while undergoing treatment for an oncologic diagnosis has not been defined, in part due to theoretical concerns for an increased risk of postoperative wound complications. We hypothesized that synchronous oncologic diagnosis conferred no increased odds of developing a wound complication in pediatric patients undergoing appendectomy.
Methods
Retrospective cohort study using the National Surgical Quality Improvement Program, Pediatric (2012–2017) of patients < 18 years of age undergoing appendectomy. The main exposure variable was active treatment for an oncologic diagnosis. The primary outcomes of interest were 30-day wound complications (superficial or deep infections or dehiscence, and abscess). For univariate analysis comparison of baseline differences between patients with/without a cancer diagnosis we employed Pearson’s χ2 and two sample t tests. Multivariate logistic regression was used to evaluate which covariates were independently associated with our outcome.
Results
We identified 28,219 patients who had undergone appendectomy; 95 (0.3%) were undergoing oncologic treatment at the time of surgery. Patients in the cancer group were more likely to be receiving steroids, have lower white blood cell counts and have higher American Society of Anesthesiology classes as compared to the noncancer patients. Age, gender, rates of perforation, and laparoscopy were similar between the two groups. Patients with an active cancer diagnosis suffered wound complications (measured individually and as an aggregate) at no higher odds than those without a cancer diagnosis.
Conclusion
Pediatric patients undergoing treatment for cancer do not have increased odds of suffering postoperative wound complications following appendectomy as compared to the general population.