Clinical features and treatment strategies of acute appendicitis in children with malignant tumors and neutropenia
10.3760/cma.j.cn101070-20240411-00225
- VernacularTitle:伴中性粒细胞缺乏症的恶性肿瘤患儿罹患急性阑尾炎的临床特点及治疗策略
- Author:
Wei CHEN
1
;
Tingchong ZHANG
;
Dayong WANG
;
Tingting LIU
;
Yajun CHEN
Author Information
1. 国家儿童医学中心(北京)，首都医科大学附属北京儿童医院普外科，北京 100045
- Keywords:
Child;
Neutropenia;
Acute appendicitis;
Malignant tumors;
Laparoscopic appendectomy
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(10):766-769
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical features and treatment strategies of acute appendicitis in children with malignant tumors and neutropenia.Methods:This was a case series report.A retrospective review was conducted on the children with malignant tumors complicated by neutropenia, who were admitted to the Beijing Children′s Hospital, Capital Medical University between March 2007 and October 2023 due to acute appendicitis.The clinical data of the patients, including demographic characteristics, clinical manifestations, laboratory tests, and treatment strategies, were collected.The Fisher′s precision probability test was performed for group comparisons of count data.The t-test was performed for normally distributed measurement data, and the non-parametric rank-sum test for non-normally distributed measurement data. Results:Twenty-four patients were included in the study.The age of the patients was 4.3 (2.9, 4.3) years, and the male-to-female ratio was 7︰1.Acute lymphoblastic leukemia (75%) was the most common type of malignancy.The main clinical manifestations were fever (92%) and abdominal pain (75%).Six patients underwent surgical treatment (5 laparoscopic surgeries)(the surgical treatment group), and 18 patients received conservative treatment(the conservative treatment group).The proportion of patients with signs of localized or diffuse peritonitis was significantly higher in the surgical treatment group (83%) than in the conservative treatment group (25%)( P=0.007).The symptomatic relief time of acute appendicitis was significantly shorter in the surgical treatment group [(1.00±0.00) days] than in the conservative treatment group [(5.50±3.60) days]( t=-4.323, P=0.001).The length of hospital stay was significantly shorter in patients who underwent laparoscopic surgery [6.00 (2.00, 8.00) days] than in patients who received conservative treatment [9.50 (6.75, 20.50) days]( Z=-2.136, P=0.033).Acute appendicitis was cured in all patients, and there were no deaths during hospitalization. Conclusions:Both surgical and conservative treatments are safe and effective for acute appendicitis in children with malignant tumors and neutropenia.Surgical treatment can relieve the symptoms of acute appendicitis more quickly, and laparoscopic appendectomy can shorten the length of hospital stay.
