Perioperative Outcomes Following Surgery for Pediatric Brain Tumors: Assessment of Eight-year Single-center Short-term Results

Abstract

Introduction: Various perioperative problems occur in patients operated on brain tumors. While many studies focused on the long-term effects of surgery, few focused on the perioperative period. The aim of this study to evaluate clinical and laboratory features and determining the factors which are effecting the outcome in operated patients for brain tumors our pediatric intensive care unit (PICU). Methods: Patients who underwent intracranial tumor surgery in the PICU during the eight-year period were retrospectively screened. Results: Seventy-four patients were included in the study, mean age was 60 (1.5-192) months, and supratentorial tumors were detected in 41 (55.4%) patients. The median length of stay (LOS) in PICU of the patients was 5 (1-150) days. When supratentorial tumor localization, ventriculoperitoneal shunt presence, central venous catheter related bloodstream infection, ventilator-associated pneumonia and other infections were evaluated, a statistically significant difference was found between the two groups when patients’ LOS in the PICU is evaluated in 2 groups of more than 15 days (77%) and less than 15 days (23%). In the postoperative period, diabetes insipidus (DI) in 12 (16%), septicemia in 9 (12%), shunt infection in 8 (10%), hydrocephalus in 7 (9%), seizures in 5 (6%), cranial nerve palsy in 5 (6%) in patients. Conclusion: Neurological sequelae increased with younger age and were more common in patients with infratentorial tumors. While a relationship was found between delta sodium and DI in the postoperative first 4 days, without relationship was found with neurological sequelae.

Keywords

• brain tumor
• child
• perioperative period problems
• pediatric intensive care
• delta sodium