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. 2025 Jul 1;41(1):201.
doi: 10.1007/s00383-025-06069-9.

Outcome analysis of surgical complications in pediatric solid tumors: a retrospective clinical study

Arihant Jain  1 , Nitin James Peters  2 , Ram Samujh  1 , Amita Trehan  3 , Muneer Abas Malik  1 , Renu Madan  4 , Shivani Dogra  1 , Shailesh Solanki  1 , Jitender Singh  1 , Ravi P Kanojia  1 , Deepak Bansal  3 , Richa Jain  3 , Monika Bawa  1 , Rakesh Kapoor  5 , Sandhya Yaddanapudi  6 , J K Mahajan  1
Affiliations

Outcome analysis of surgical complications in pediatric solid tumors: a retrospective clinical study

Arihant Jain et al. Pediatr Surg Int. .

Abstract

Purpose: Postoperative complications can significantly impact patient outcomes and quality of life, particularly in children with solid tumors. These complications may delay the commencement of adjuvant therapy. This study aimed to evaluate the severity and effects of these complications and to validate the Clavien-Dindo classification system in pediatric patients following surgery for solid tumors.

Methods: A retrospective analysis was conducted on postoperative complications in children with solid tumors at a tertiary care teaching hospital over 5 years. Patient demographics and tumor types were recorded, and complications were categorized using the Clavien-Dindo classification. The study identified key risk factors for complications and their implications for patient care.

Results: We included 188 patients, out of which the majority (n = 157; 83.5%) had low-grade (grade 1 or 2) postoperative complications. Higher intraoperative blood loss (p < 0.001), adjacent organ infiltration, and longer operative times were associated with more severe grade of complications. Patients with higher-grade complications also had longer hospital stays (Kendall's Tau coefficient of 0.48). Among the 26 patients with tumor recurrence, 30% had experienced severe complications (grades 3 and 4). The Kaplan‒Meier curve and log-rank test (p < 0.001) showed that severe complications are linked to a lower survival probability.

Conclusions: The analysis of complications showed a significant effect on short-term surgical outcomes, and severe complications may also impact oncological outcomes. The Clavien-Dindo classification is a useful tool for grading postoperative complications in pediatric surgical oncology.

Level of evidence: Level III.

Keywords: Adjuvant therapy; Clavien–Dindo classification; Interleukin-6; Pediatric solid tumors; Postoperative complications; Quality improvement.

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Conflict of interest statement

Declarations. Conflict of interests: The authors declare no competing interests.

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