Peel T, May D, Buising K, Thursky K, Slavin M, Choong P
Department of Surgery, St Vincent's Hospital, University of Melbourne, Regent Street, Fitzroy, VIC 3065, Australia; Department of Infectious Diseases, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia; Department of Orthopaedics, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia.
Department of Orthopaedics, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia.
Eur J Surg Oncol. 2014 Sep;40(9):1087-94. doi: 10.1016/j.ejso.2014.02.241. Epub 2014 Mar 4.
This study aims to describe the incidence of infective complications, including tumour endoprosthesis infection, in a cohort of patients undergoing tumour endoprosthesis surgery in Victoria, Australia.
This retrospective cohort study was performed over 15 years (January 1996-December 2010).
121 patients underwent tumour endoprosthesis surgery during the study period. Patients were followed for a median of 34 months (interquartile range [IQR] 17, 80). Overall, 34 patients (28%) experienced infective complications including: bacteraemia in 19 patients (16%) and tumour endoprosthesis infection in 17 (14%). The majority of patients with early and late acute infections (haematogenous) were managed with debridement and retention of the prosthesis in addition to biofilm-active antibiotics. Late chronic infections were predominantly managed by exchange of the prosthesis. The overall success rate of treatment was 71%. The success rate for debridement and retention was 75% compared with 67% for exchange procedures.
There is a significant rate of infective complications following tumour endoprosthesis surgery including 14% of patients experiencing infection involving the tumour endoprosthesis. This study is the first to report on outcomes from debridement and retention of the prosthesis; which had comparable success rates to other treatment modalities.
本研究旨在描述在澳大利亚维多利亚州接受肿瘤人工关节置换手术的一组患者中感染性并发症的发生率，包括肿瘤人工关节感染。
这项回顾性队列研究历时15年（1996年1月至2010年12月）。
在研究期间，121例患者接受了肿瘤人工关节置换手术。患者的中位随访时间为34个月（四分位间距[IQR]为17, 80）。总体而言，34例患者（28%）出现感染性并发症，包括：19例患者（16%）发生菌血症，17例患者（14%）发生肿瘤人工关节感染。大多数早期和晚期急性感染（血源性）患者除使用具有生物膜活性的抗生素外，还接受了清创术并保留假体。晚期慢性感染主要通过更换假体进行处理。总体治疗成功率为71%。清创术并保留假体的成功率为75%，而更换假体手术的成功率为67%。
肿瘤人工关节置换手术后感染性并发症的发生率较高，包括14%的患者发生涉及肿瘤人工关节的感染。本研究首次报告了清创术并保留假体的治疗结果，其成功率与其他治疗方式相当。
