Clinical features and treatment strategies of acute appendicitis in children with malignant tumors and neutropenia
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.
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