title: Surgical management of stem cell transplantation-related complications in children.
abstract: HSCT is an established treatment option for some children with life-threatening diseases, but complications remain a major cause of morbidity and mortality. This retrospective data analysis addresses the surgical issues of children with HSCT-related complications. Between 2002 and 2008, HSCT was performed in 240 children for leukemias/lymphomas (n=135), solid tumors (n=59), immunodeficiencies (n=20), lipid storage diseases (n=10), autoimmune diseases (n=9), and others (n=7). HSCT-related complications requiring surgery occurred in 24 cases (10%) and most often in the leukemias/lymphomas group (18/24 cases): HC (cystoscopic irrigation, n=7), pulmonary aspergilloses (resection, n=7), bone necroses (core decompression, n=3), GvHD bowel (colostomy/PEG, n=2), ICH (drainage, n=2), bilateral kidney abscess (nephrectomies/renal transplantation, n=1), aspergillosis of the maxillary sinus (decompression, n=1), and post-traumatic wound healing disorder (meshed skin transplantation, n=1). Survival was 50% in the group with surgery and 62% in the group without (p=0.275). Even though this difference was not statistically significant, surgical intervention should be encouraged in all cases to achieve favorable results.
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital, Tuebingen, Germany. justuslieber@me.com
authors.forename: Justus
authors.initials: J
authors.lastname: Lieber
authors.forename: Holger
authors.initials: H
authors.lastname: Hauch
authors.forename: Peter
authors.initials: P
authors.lastname: Lang
authors.forename: Rupert
authors.initials: R
authors.lastname: Handgretinger
authors.forename: Gunnar
authors.initials: G
authors.lastname: Blumenstock
authors.forename: Guido
authors.initials: G
authors.lastname: Seitz
authors.forename: Steven W
authors.initials: SW
authors.lastname: Warmann
authors.forename: Jörg
authors.initials: J
authors.lastname: Fuchs
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D009181:Mycoses / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D016017:Odds Ratio; D010020:Osteonecrosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult