Karaca Mustafa Onur, Özbek Emre Anıl, Özyıldıran Mustafa, Merter Abdullah, Başarır Kerem, Yıldız Hüseyin Yusuf, Sağlık Yener
Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06230 Altındağ, Ankara, Türkiye.
Jt Dis Relat Surg. 2022;33(1):132-141. doi: 10.52312/jdrs.2022.560. Epub 2022 Mar 28.
This study aims to investigate the factors that may be associated with surgical site infection and mortality in pelvic resection surgeries.
A total of 68 patients (40 males, 28 females; mean age: 43±16.2 years; range, 11 to 70 years) who underwent internal or external hemipelvectomy between January 2010 and January 2020 were retrospectively analyzed. We reviewed data concerning histopathological diagnosis, surgical technique, pelvic resection type, tumor size, postoperative infection, duration of follow-up, and mortality.
The mean follow-up was 45.5±42.2 months. Among 68 patients, 29 (42.6%) cases underwent external hemipelvectomy and 39 (57.4%) cases underwent internal hemipelvectomy. Reconstruction was performed in 14 (20.6%) patients who underwent internal hemipelvectomy. Of all patients, 61 had primary malignant pelvic tumors and two had metastatic pelvic tumors. Of the other five patients, two had a giant cell tumor, two had a pelvic hydatid cyst, and one had an aneurysmal bone cyst. The three most common pelvic tumors were chondrosarcoma (n=25, 36.7%), osteosarcoma (n=13, 19.1%), and Ewing sarcoma (n=8, 11.8%). Surgical site infections were observed in 34 (50.0%) patients. Of 34 patients, 15 (22.1%) had superficial infections and 19 (27.9%) had deep surgical infections. The superficial and deep infection rates were higher in the external hemipelvectomy group compared to internal hemipelvectomy (p=0.02). Patients with postoperative infection had a mean survival period of 36.0 months compared to 79.8 months in patients without infection (p=0.037). The patients treated with internal hemipelvectomy had a mean survival of 97.0 months compared to 25.7 months in patients treated with external hemipelvectomy (p<0.0001). The effect of Enneking stages of malignant pelvic tumors on survival was investigated using the Kaplan-Meier analysis. Cumulative survival decreased, as the stage progressed (p<0.0001).
The type of surgical technique affects the possibility of postoperative infection. Postoperative infection, surgical method, and stage of the tumor are associated with survival.
本研究旨在调查骨盆切除术手术部位感染和死亡率可能相关的因素。
回顾性分析2010年1月至2020年1月期间接受内半骨盆切除术或外半骨盆切除术的68例患者（40例男性，28例女性；平均年龄：43±16.2岁；范围11至70岁）。我们查阅了有关组织病理学诊断、手术技术、骨盆切除类型、肿瘤大小、术后感染、随访时间和死亡率的数据。
平均随访时间为45.5±42.2个月。68例患者中，29例（42.6%）接受了外半骨盆切除术，39例（57.4%）接受了内半骨盆切除术。14例（20.6%）接受内半骨盆切除术的患者进行了重建。所有患者中，61例患有原发性恶性骨盆肿瘤，2例患有转移性骨盆肿瘤。其他5例患者中，2例患有骨巨细胞瘤，2例患有骨盆包虫囊肿，1例患有动脉瘤样骨囊肿。三种最常见的骨盆肿瘤是软骨肉瘤（n = 25，36.7%）、骨肉瘤（n = 13，19.1%）和尤因肉瘤（n = 8，11.8%）。34例（50.0%）患者发生了手术部位感染。在34例患者中，15例（22.1%）发生浅表感染，19例（27.9%）发生深部手术感染。外半骨盆切除术组的浅表和深部感染率高于内半骨盆切除术组（p = 0.02）。术后感染患者的平均生存期为36.0个月，而未感染患者为79.8个月（p = 0.037）。接受内半骨盆切除术的患者平均生存期为97.0个月，而接受外半骨盆切除术的患者为25.7个月（p<0.0001）。采用Kaplan-Meier分析研究恶性骨盆肿瘤的Enneking分期对生存率的影响。随着分期进展，累积生存率下降（p<0.0001）。
手术技术类型影响术后感染的可能性。术后感染、手术方法和肿瘤分期与生存率相关。
