Gonzalez Marcos R, Karczewski Daniel, Bedi Angad D S, Denwood Hayley, Lozano-Calderon Santiago A
Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Orthopaedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Surg Oncol. 2023 Aug;128(2):367-374. doi: 10.1002/jso.27290. Epub 2023 Apr 20.
Soft tissue (ST) complications after resection of bone and ST sarcomas of the pelvis occur more frequently than in appendicular tumors. We sought to identify risk factors for complications within 30 days of surgery.
The National Surgical Quality Improvement Program database was used for this study. Patients with sarcomas of bone and ST of the pelvis were retrieved using Current Procedural Terminology and International Classification of Diseases codes. Outcomes assessed were ST complications, overall complication rates, 30-day reoperation, and mortality.
A total of 770 patients with pelvic bone and ST sarcoma were included. The ST complication rate was 12.6%, including 4.9% superficial and 4.7% deep surgical site infections. Higher ST complication rates were seen in patients >30 years, with partially dependent health status, hematocrit <30%, bone tumors, tumor >5 cm, amputation procedures, and longer operative times. ST complication rates were 1.5 and 3 times higher in pelvic sarcoma surgeries than in the lower and upper extremities, respectively. Age >30 years (odds ratio [OR] = 5.07), hematocrit <30% (OR = 1.84), operative time 1-3 h (OR = 2.97), and >3 h (OR = 4.89) were risk factors for ST complications.
One in nine patients with pelvic sarcoma surgery will develop ST complications within 30 days. Risk factors for ST complications were age >30, hematocrit <30%, and longer operative time.
骨盆骨与软组织肉瘤切除术后的软组织(ST)并发症比四肢肿瘤更为常见。我们试图确定术后30天内发生并发症的风险因素。
本研究使用国家外科质量改进计划数据库。通过当前手术操作术语和国际疾病分类代码检索骨盆骨与软组织肉瘤患者。评估的结果包括ST并发症、总体并发症发生率、30天再次手术率和死亡率。
共纳入770例骨盆骨肉瘤和软组织肉瘤患者。ST并发症发生率为12.6%,包括4.9%的表浅和4.7%的深部手术部位感染。年龄>30岁、健康状况部分依赖、血细胞比容<30%、骨肿瘤、肿瘤>5 cm、截肢手术以及手术时间较长的患者ST并发症发生率较高。骨盆肉瘤手术的ST并发症发生率分别比下肢和上肢手术高1.5倍和3倍。年龄>30岁(优势比[OR]=5.07)、血细胞比容<30%(OR=1.84)、手术时间1 - 3小时(OR=2.97)和>3小时(OR=4.89)是ST并发症的风险因素。
骨盆肉瘤手术患者中,每九人中有一人会在30天内发生ST并发症。ST并发症的风险因素为年龄>30岁、血细胞比容<30%和手术时间较长。