Branco E Silva Mayara, Branco E Silva Mayara, Conceição Maia Martins Samilly, Voltan Garofo Karen, Eduardo Hideo Hanasilo Carlos, Etchebehere Mauricio
Department of Orthopedics, Rheumatology and Traumatology, Faculty of Medical Sciences, The State University of Campinas (FCM - UNICAMP), Tessalia Vieira de Carvalho Avenue, 126, Campinas 13083-887, Brazil.
J Bone Oncol. 2022 Jul 16;35:100445. doi: 10.1016/j.jbo.2022.100445. eCollection 2022 Aug.
Sacrectomy is indicated for the resection of life-threatening tumors in the sacrum area. Several studies have been conducted to investigate important aspects of sacrectomy to help reduce the morbidity and mortality of patients who underwent the procedure. This aim of this systematic review was to highlight the prognoses of patients who underwent sacrectomy for the resection of primary bone tumors by analyzing information related to the intraoperative and perioperative periods of the procedure.
Several databases were searched for relevant articles using the keywords "sacrectomy" and "survival" associated with the Boolean operators "or" and "and" ([SACRECTOMY OR SACRECTOM*] AND SURVIVAL).
A total of 13 articles were selected for data collection. The studies reported in the articles included a total of 384 patients, 140 of whom underwent partial sacrectomy, whereas 244 underwent total sacral resections. The results of the analysis indicated that the average volume of blood lost during a resection performed using the combined anterior and posterior approaches (average duration, 8.35 h) was 4571.94 mL. Regarding poor outcomes and adverse events in the included studies, 10 patients died in the early postoperative period, whereas four patients had hemorrhagic shock. The most prevalent complications reported were surgical wound infection and sphincter dysfunction.
The optimal surgical approach for sacrectomy depends on the location of the tumor. The anterior approach, preferably with laparoscopy, is currently widely used to reduce the amount of blood lost during the procedure. Although the most prevalent complications of sacrectomy have a high incidence rate, the procedure has a low mortality rate.
骶骨切除术适用于切除骶骨区域危及生命的肿瘤。已经开展了多项研究来调查骶骨切除术的重要方面，以帮助降低接受该手术患者的发病率和死亡率。本系统评价的目的是通过分析与手术中及围手术期相关的信息，突出接受骶骨切除术以切除原发性骨肿瘤患者的预后情况。
使用与布尔运算符“或”和“与”相关联的关键词“骶骨切除术”和“生存率”（[骶骨切除术或骶骨切除*]与生存率）在多个数据库中搜索相关文章。
共选择13篇文章进行数据收集。文章中报道的研究共纳入384例患者，其中140例行部分骶骨切除术，244例行全骶骨切除术。分析结果表明，采用前后联合入路进行切除时（平均时长8.35小时），平均失血量为4571.94毫升。关于纳入研究中的不良结局和不良事件，10例患者在术后早期死亡，4例患者发生失血性休克。报道的最常见并发症是手术伤口感染和括约肌功能障碍。
骶骨切除术的最佳手术入路取决于肿瘤的位置。目前广泛采用前路入路，最好是腹腔镜手术，以减少手术过程中的失血量。虽然骶骨切除术最常见的并发症发生率较高，但该手术的死亡率较低。
