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首页> 外文期刊>Child's nervous system: ChNS : official journal of the International Society for Pediatric Neurosurgery >Predicting dysphagia in children undergoing surgery for posterior fossa tumors
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Predicting dysphagia in children undergoing surgery for posterior fossa tumors

机译：预测后窝肿瘤手术的儿童吞咽困难

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Purpose Posterior fossa tumors (PFTs) are the most common type of brain tumor in children. Dysphagia is a known complication of PFT resection in children, but data regarding risk factors and clinical course are sparse. Methods The records of all children who underwent resection of posterior fossa tumor between April 2007 and May 2017 at our institution were analyzed. Clinical, radiographic, histologic data were gathered. Swallowing function was assessed immediately postoperatively and at 1-year follow-up. Results A total of 197 patients were included. Forty-three (21.8%) patients developed dysphagia after surgery. Patients who developed dysphagia were younger (4.5 vs. 7.2 years, p < 0.01), were more likely to have brainstem compression (74.4% vs. 57.8%, p < 0.03) or invasion (14.0 vs. 9.7%, p < 0.03), and were more likely to have ependymoma (27.9% vs. 13.6%, p < 0.01) or ATRT (atypical teratoid/rhabdoid tumor) (9.3% vs. 3.9%, p < 0.01). Patients with postoperative dysphagia also had a longer length of stay (33.7 vs. 12.7 days, p < 0.01) and were more likely to be discharged to inpatient rehabilitation (25.6% vs. 9.1%, p < 0.01). Ten patients (5.1%) were PEG-dependent by 1-year follow-up. These patients were younger (2.7 vs. 5.6 years, p < 0.01), had a longer length of stay (55.5 vs. 27.4 days, p < 0.01), and were more likely to have ATRT (30.0% vs. 0.0%, p < 0.01). Recovery was not associated with tumor grade or extent of resection. Conclusions Dysphagia after PFT resection is associated with younger age, aggressive tumor histology, and increased healthcare utilization. While most patients recover, a small percentage are still dependent on enteral feeding at 1-year follow-up. Further research is needed to identify factors associated with persistent deficits.
机译：目的后窝肿瘤（PFT）是儿童中最常见的脑肿瘤类型。吞咽困难是儿童PFT切除的已知并发症，但有关风险因素和临床课程的数据稀疏。方法分析了2007年4月和2017年5月在我们的机构切除后窝肿瘤的所有儿童的记录。临床，射线照相，组织学数据被聚集在一起。吞咽术后立即评估吞咽功能，并在1年的随访中进行评估。结果共有197名患者。四十三（21.8％）患者在手术后开发了吞咽困难。开发吞咽困难的患者更年轻（4.5 vs.2岁，P <0.01）更可能具有脑干压缩（74.4％与57.8％，P <0.03）或侵袭（14.0 vs.9.7％，P <0.03） ，并且更有可能具有Endencoma（27.9％对13.6％，P <0.01）或ATRT（非典型Teratoid / Rhabdoid肿瘤）（9.3％vs.3.9％，P <0.01）。患有术后吞咽的患者也具有更长的逗留时间（33.7节，12.7天，P <0.01），更有可能被排放到住院性康复（25.6％vs.9.1％，P <0.01）。 10名患者（5.1％）依赖于1年的随访。这些患者年轻（2.7 vs. 5.6岁，P <0.01），保持寿命长度较长（55.5 vs.2.4天，P <0.01），并且更有可能具有ATRT（30.0％与0.0％，p <0.01）。恢复与肿瘤等级或切除程度无关。结论PFT切除后吞咽困难与年龄较小，侵袭性肿瘤组织学和增加的医疗利用率相关。虽然大多数患者恢复，但小百分比仍然依赖于1年随访时的肠内喂养。需要进一步的研究来识别与持续赤字相关的因素。

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