Qiao Zhihong, Jia Ningyang, He Qian
Department of Imaging, Shanghai Eastern Hepatobiliary Surgery Hospital, Shanghai, China Department of Imaging, Shanghai Armed Police Corps Hospital, Shanghai, China.
Department of Imaging, Shanghai Eastern Hepatobiliary Surgery Hospital, Shanghai, China
Interv Neuroradiol. 2015 Feb;21(1):129-35. doi: 10.15274/inr-2014-10091.
This paper aimed to evaluate the effect of preoperative transarterial embolization (TAE) on estimated blood loss (EBL) during surgical excision of the vertebral tumors. Three hundred and forty-eight patients with spinal tumors were retrospectively analyzed. The preoperative TAE group consisted of 190 patients and the control group consisted of 158 patients. Gelatin sponge particles mixed withy contrast agent were used in the TAE group to embolize the tumor-feeding artery. The factors evaluated included: the time interval between embolism and surgery; the number of vertebrae involved by the tumor; pathological type of tumor; surgical approach; extent of excision and instrumental fixation. The time interval (P = 0.4669)between embolism and surgery had no significant correlation with EBL during surgery. The pathological diagnosis of vertebral tumor such as plasma cell myeloma, giant cell tumor, chondrosarcoma, hemangioma and metastasis had no significant correlation with EBL between the TAE group and control group during surgery, while the EBL of chordoma in the TAE group was significantly higher than that in the control group (p = 0.0254). The number of vertebrae involved (p = 0.4669, 0.6804, 0.6677), posterior approach (p = 0.3015), anterior approach (p = 0.2446), partial excision (p = 0.1911) and instrumental fixation (p = 0.1789) had no significant correlation with EBL during surgery between the TAE group and the control group. This study showed that preoperative TAE of the spinal tumor had no significant effect on intra-operative blood loss during surgical excision of the spinal tumor. In view of the risk of embolism, this method should be carefully considered.
本文旨在评估术前经动脉栓塞术（TAE）对椎体肿瘤手术切除过程中估计失血量（EBL）的影响。对348例脊柱肿瘤患者进行了回顾性分析。术前TAE组由190例患者组成，对照组由158例患者组成。TAE组使用与造影剂混合的明胶海绵颗粒栓塞肿瘤供血动脉。评估的因素包括：栓塞与手术之间的时间间隔；肿瘤累及的椎体数量；肿瘤的病理类型；手术入路；切除范围和器械固定。栓塞与手术之间的时间间隔（P = 0.4669）与手术期间的EBL无显著相关性。椎体肿瘤的病理诊断，如浆细胞骨髓瘤、巨细胞瘤、软骨肉瘤、血管瘤和转移瘤，在TAE组和对照组手术期间与EBL无显著相关性，而TAE组脊索瘤的EBL显著高于对照组（p = 0.0254）。TAE组和对照组手术期间，累及的椎体数量（p = 0.4669、0.6804、0.6677）、后路入路（p = 0.3015）、前路入路（p = 0.2446）、部分切除（p = 0.1911）和器械固定（p = 0.1789）与EBL无显著相关性。本研究表明，脊柱肿瘤术前TAE对脊柱肿瘤手术切除过程中的术中失血量无显著影响。鉴于栓塞风险，应谨慎考虑该方法。
