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儿童原发性腹膜后畸胎瘤的特点及围手术期并发症的影响因素

The characteristics of pediatric primary retroperitoneal teratoma and the influencing factors of perioperative complications

摘要探讨儿童原发性腹膜后畸胎瘤特点及围手术期并发症影响因素。回顾性分析2013年3月至2023年9月山西省儿童医院收治的原发性腹膜后畸胎瘤患儿的临床资料、影像资料、病理结果、围手术期并发症等,并根据有无围手术期并发症,将患儿分为无并发症组与并发症组,比较2组间的差异,并通过多因素logistic回归模型分析并发症的影响因素。共纳入33例患儿,男7例,女26例,年龄[ M( Q1, Q3)]为9.0(4.0,24.0)个月;肿瘤位于左上腹者19例,右上腹者14例,其中17例跨中线生长,肿瘤最大径(12.9±4.5)cm。所有患儿均有腹膜后血管及器官解剖移位:动脉解剖移位数量为3(3,4)个;静脉解剖移位数量为4(3,5)个;器官解剖移位数量为5(4,6)个。病理结果显示:成熟性畸胎瘤(Grade 0+Grade 1)28例,未成熟性畸胎瘤(Grade 2+Grade 3)5例。无并发症组18例,并发症组15例,围手术期并发症发生率为45.5%(15/33)。2组患儿肿瘤过中线的例数比(6/18比11/15, P=0.037)、肿瘤与周围组织粘连紧密的例数比(7/18比12/15, P=0.033)、静脉解剖移位的数量[4(3,4)比5(4,5)个, P=0.001]、器官解剖移位的数量[4(3,5)比6(5,6)个, P=0.001]差异有统计学意义。多因素logistic回归模型分析显示:器官解剖移位数量( OR=8.781,95% CI:2.155~35.784, P=0.002)是原发性腹膜后畸胎瘤患儿围手术期并发症的影响因素。

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abstractsTo explore the characteristics of pediatric primary retroperitoneal teratoma and the influencing factors of perioperative complications. The clinical data, imaging data, pathology results, perioperative complications, etc of patients with primary retroperitoneal teratoma admitted and treated at Shanxi Children ′s Hospital from March 2013 to September 2023 were retrospectively analyzed. The patients were divided into no complication group and complication group according to whether there were perioperative complications. The differences between the two groups were compared, and the influencing factors of complications were analyzed by multivariate logistic regression model. A total of 33 patients were included in this study, including 7 males and 26 females, with an age of [ M ( Q1, Q3), 9.0 (4.0, 24.0)] months. Nineteen cases had tumors located in the left upper abdomen and 14 cases in the right upper abdomen, among which 17 cases grew across the midline, with the maximum tumor diameter of (12.9±4.5) cm. All patients had anatomical displacement of retroperitoneal vessels and organs: the number of anatomical displaced arteries was 3 (3, 4), the number of anatomical displaced veins was 4 (3, 5), the number of anatomical displaced organs was 5 (4, 6). Pathologic examination revealed 28 mature teratomas (Grade 0 and Grade 1) and 5 immature teratomas (Grade 2 and Grade 3). There were 18 cases in no complication group and 15 cases in the complication group. The incidence of perioperative complications was 45.5% (15/33). The number of tumors crossing the midline (6/18 vs 11/15, P=0.037), the number of tumors adhering closely to the surrounding tissues (7/18 vs 12/15, P=0.033), the number of anatomical displaced veins [4 (3, 4) vs 5 (4, 5), P=0.001], and the number of anatomical displaced organs [4 (3, 5) vs 6 (5, 6), P=0.001] were significantly different between the two groups. Multivariate logistic regression model analysis showed that the number of anatomical displaced organs ( OR=8.781, 95% CI: 2.155-35.784, P=0.002) was the influencing factor for perioperative complications of pediatric primary retroperitoneal teratoma.

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