Outcomes of surgical treatment for hemangiomas.

Abstract

To quantify complications and rates of adverse events associated with surgical excision of hemangiomas in children using a national surgical database. Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program® (ACS NSQIP® -pediatric), years 2012-2016. Subjects included children under 18years with a postoperative diagnosis of International Classification of Diseases (ICD), 9th revision code: 228.00 and 228.01, or ICD 10 codes D18.00 and D18.01-hemangioma, any site and hemangioma, of skin and subcutaneous tissue. A total of 1180 patients were included. The median age was 3.2years (interquartile range [IQR] 1.2 to 6.4years old). No occurrences of deep incisional surgical site infection, nerve injury, mortality, sepsis, septic shock, or blood stream infections were noted. In multivariate analysis, age ≤ 3years and advanced American Society of Anesthesiologists class were significant predictors of adverse events (P=0.035 and 0.001, respectively). For children with infantile hemangioma who fail to respond or have an incomplete response to medical therapy, surgical resection may be a relatively safe treatment alternative. Children older than 3years of age with hemangiomas had less surgical adverse events than younger children. Overall, however, the surgical complications rates were low and deemed relatively minor.