Department of Orthopaedic Surgery, Kyorin University Faculty of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
J Orthop Sci. 2024 Sep;29(5):1300-1305. doi: 10.1016/j.jos.2023.08.002. Epub 2023 Aug 19.
Postoperative infection is a devastating complication in limb salvage surgery for malignant soft tissue tumors. The low absolute case numbers of these rare cancers represent a bottleneck for data collection and analysis. The administration of nationwide registry data is a practical option for the accumulation of cases.
Data on malignant soft tissue tumor resection were extracted from the Bone and Soft Tissue Tumor Registry in Japan. The incidence of postoperative infection and its risk factors were analyzed.
A total of 14,460 cases were included. The incidence of infection was 2.6%. Significant risks for infection were male sex, lower extremity or trunk location, tumor diameter of over 10 cm, trans-compartmental invasion, high grade, autologous bone graft, myocutaneous flap, vascular reconstruction, reconstruction by prosthesis, postoperative radiotherapy, and delayed wound healing.
The incidence was lower than those in the previous studies, perhaps because of less frequent radiotherapy application. Some of the significant risk factors represented local invasiveness of the tumor, suggesting the importance of the preservation of soft tissue for infection prevention. The administration of nationwide registry data was informative for the analysis of infection in malignant soft tissue tumor resection.
术后感染是恶性软组织肿瘤保肢手术的一种毁灭性并发症。这些罕见癌症的绝对病例数较少，这代表着数据收集和分析的瓶颈。管理全国性的登记数据是积累病例的一种实用选择。
从日本的骨与软组织肿瘤登记处提取了恶性软组织肿瘤切除的数据。分析了术后感染的发生率及其危险因素。
共纳入 14460 例患者。感染发生率为 2.6%。感染的显著危险因素为男性、下肢或躯干部位、肿瘤直径>10cm、跨筋膜间隙侵犯、高级别、自体骨移植、肌皮瓣、血管重建、假体重建、术后放疗和伤口愈合延迟。
感染发生率低于以往的研究，这可能是由于放疗应用较少。一些显著的危险因素代表肿瘤的局部侵袭性，这表明为预防感染保留软组织的重要性。管理全国性的登记数据对于分析恶性软组织肿瘤切除术后的感染情况具有信息价值。
