What is the role of surgery in the treatment of pediatric chronic granulomatous disease (CGD)?

Updated: Aug 07, 2019
  • Author: Lawrence C Wolfe, MD; Chief Editor: Cameron K Tebbi, MD  more...
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Answer

Despite the increased risk of wound healing associated with surgical intervention, surgery is still an important tool for these patients.

Surgery may be required to relieve obstruction of ureters from large granulomas, drainage of abscesses, and aggressive removal of established infection, especially in the lung and liver.

Patients who require surgery are at risk for postoperative wound infections and sepsis due to catalase-producing organisms, especially S aureus.

A retrospective study by Feingold et al of patients with chronic granulomatous disease found that those undergoing thoracic surgery (stemming from persistent pulmonary infections) was accompanied by significant morbidity and a relatively poor long-term survival rate, with the hazard ratio for death rising to 3.71. In the study, 35 out of 258 patients required thoracic surgery, with overall survival probabilities at 5- and 10-year follow-up calculated at 75% and 62%, respectively. Negative prognostic factors included chest wall resection and an estimated blood loss of over 500 mL. [24]


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