Postoperative Complications in Pediatric Brain Tumor Surgery in Latin America: A Systematic Review and Meta-Analysis
Notice bibliographique
Résumé
Abstract Pediatric brain tumors are one of the most common causes of cancer-related death in children. Surgical resection is the primary treatment of choice; however, postoperative complications can impact outcomes, particularly in low- and middle-income countries. The current systematic review and meta-analysis estimated the burden and evaluated the risk factors related to the postoperative complications of pediatric brain tumor surgery in Latin America, and compared the outcomes to those of European cohorts. Following the 2020 Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement (PROSPERO ID: CRD420251124110), we conducted searches on the PubMed, Scopus, Web of Science, Embase, SciELO, and LILACS databases for studies published f from inception until June 30, 2025 on the postoperative complications of patients aged ≤ 18 years undergoing brain tumor resection in Latin America. The studies included had to have a sample size ≥ 30 individuals and report at least one of the following outcomes: surgical site infection, hemorrhage, new neurological deficit, or mortality. The secondary outcomes included altered sodium levels after surgery. Pooled data were analyzed using DerSimonian-Laird random-effects models, and indirect comparisons were made with contemporary studies from Europe and the United States. A total of 26 studies (from 10 countries and including 3,472 patients) met the inclusion criteria, and 21 were included in the current meta-analysis. The pooled complication rates were as follows: infection – 12.8% (95%CI: 10.1–15.7%); hemorrhage – 6.4% (95%CI:4.5–8.6%); neurological deficits – 18.5% 95%CI: 14.7–22.6%; and 30-day mortality – 4.2% (95%CI: 2.8–5.8%). Alterations in sodium levels were noted in 7.6% (95%CI: 5.0–10.5%) due to hyponatremia, and in 4.3% (95%CI: 2.5–6.5%) due hypernatremia, often in the context of posterior fossa and suprasellar tumors. Regarding regional benchmarks, the lowest complication rates in Latin America were found in Uruguay, and the highest, in Bolivia, Venezuela, and Honduras (risk ratio [RR] of up to 2.25). The risk factors included: age < 3 years, tumor size > 5cm, operative time > 5 hours, and limited access to pediatric intensive care in countries with few specialized pediatric surgical centers. The postoperative infection and mortality rates following pediatric brain tumor surgery are significantly higher in Latin America than in Europe and the United States; this reflects disparities in the perioperative infrastructure and in the ability to deliver specialized care. Strengthen infection control, facilitate access to pediatric intensive care, and the standardization of sodium monitoring protocols should be priorities to improve the outcomes.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».