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Outcomes of surgical treatment for hemangiomas
Author(s) -
Cheng Jeffrey,
Liu Beiyu,
Lee HuiJie
Publication year - 2019
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13751
Subject(s) - medicine , interquartile range , adverse effect , hemangioma , surgery , sepsis , medical record , confidence interval , septic shock , pediatrics
Objective To quantify complications and rates of adverse events associated with surgical excision of hemangiomas in children using a national surgical database. Data source Pediatric American College of Surgeons ( ACS ) National Surgical Quality Improvement Program ® ( ACS NSQIP ® ‐pediatric), years 2012‐2016. Methods Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases ( ICD ), 9th revision code: 228.00 and 228.01, or ICD 10 codes D18.00 and D18.01—hemangioma, any site and hemangioma, of skin and subcutaneous tissue. Results A total of 1180 patients were included. The median age was 3.2 years (interquartile range [ IQR ] 1.2 to 6.4 years old). No occurrences of deep incisional surgical site infection, nerve injury, mortality, sepsis, septic shock, or blood stream infections were noted. In multivariate analysis, age ≤ 3 years and advanced American Society of Anesthesiologists class were significant predictors of adverse events ( P = 0.035 and 0.001, respectively). Conclusions For children with infantile hemangioma who fail to respond or have an incomplete response to medical therapy, surgical resection may be a relatively safe treatment alternative. Children older than 3 years of age with hemangiomas had less surgical adverse events than younger children. Overall, however, the surgical complications rates were low and deemed relatively minor.