Hepatic resections for pediatric hepatoblastoma: analysis of 30-day outcomes using the National Surgical Quality Improvement Program—Pediatric database
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In brief
In brief
This study analyzes 30-day outcomes for 458 children undergoing hepatic resection for hepatoblastoma using national registry data. Results show excellent safety profiles with low complication rates across all resection types, though trisectionectomy patients required higher transfusion volumes. Extended resections did not demonstrate worse short-term outcomes despite increased complexity.
- Hepatic resection for hepatoblastoma has excellent 30-day outcomes with low complication rates in pediatric patients.
- Perioperative blood transfusion (64.2%) is common; median transfusion volume is 15.7 ml/kg across all resection types.
- Trisectionectomy carries 3.4× higher odds of requiring larger transfusion volumes (>75th percentile) compared to standard resections.
- Extended hepatic resections do not show worse 30-day outcomes despite increased operative complexity and duration.
- Postoperative ventilation >48 hours occurs in 10% of cases and is more common with extended resections.
Written by the GCMD Library team from the article.
Abstract
Background
Surgical resection remains the cornerstone of treatment for hepatoblastoma in children and offers the best chance of disease-free survival. We aimed to analyze the 30 day outcomes of hepatic resection for hepatoblastoma stratified by extent using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P).
Methods
We queried NSQIP-P for children undergoing resection of Hepatoblastoma from 2012 to 2021. Relevant clinical characteristics and outcomes were extracted for multivariate logistic regression to identify predictors of common adverse outcomes.
Results
We included 458 children with a median age of 1.90 years. Overall complications were rare, and perioperative blood transfusion (64.2%) and postoperative ventilation > 48 h (10.0%) were the only adverse events prevalent in more than 5% of patients. Median transfusion volume was 15.7 ml/kg. On multivariate regression, only patients undergoing Trisectionectomy (aOR = 3.387, 95% C.I. = 1.348–8.510) had higher odds of receiving > 75th percentile blood transfusion. Furthermore, only perioperative transfusion and postoperative ventilation > 48 h were statistically more common in patients undergoing extended versus standard resections.
Conclusions
Outcomes following resection of hepatoblastoma are excellent, with low rates of postoperative adverse events. Although children undergoing trisectionectomy likely require greater transfusion volume, extended hepatic resections do not appear to have worse 30 day outcomes despite greater operative complexity and duration.