Heesen Philip, Elyes Maria, Domanski Jan, Schelling Georg, Könneker Sören, Fuchs Bruno
Department of Plastic & Reconstructive Surgery, University Hospital USZ, University of Zurich, 8000 Zurich, Switzerland.
Department of Orthopedics & Trauma, Sarcoma Service, LUKS University Hospital, University of Lucerne, 6000 Lucerne, Switzerland.
J Clin Med. 2024 May 2;13(9):2681. doi: 10.3390/jcm13092681.
: This study investigates the risk factors associated with postoperative complications in musculoskeletal tumor surgeries and evaluates the impact of benchmarking in enhancing surgical outcomes. : Conducted at a tertiary referral center, this retrospective analysis included 196 patients who underwent surgeries for various musculoskeletal tumors, ranging from soft tissue to bone sarcomas. Patient and tumor characteristics, along with surgical interventions and outcomes, were comprehensively assessed using the Charlson Comorbidity Index and the Clavien-Dindo classification. : Key findings indicate that surgical reconstruction, ASA 3 status, bone tumor presence, and the need for multiple erythrocyte transfusions significantly increase postoperative morbidity. Notably, no significant correlation was found between the Charlson Comorbidity Index scores and the occurrence or severity of complications, challenging the utility of this index in predicting short-term surgical outcomes. : This study highlights the importance of tailored surgical approaches and emphasizes rigorous preoperative assessments to mitigate risks and enhance patient care. Despite its insights, limitations include its retrospective nature and single-center scope, suggesting a need for broader, multicenter studies to generalize findings. Overall, our results underscore the necessity of integrating clinical assessments with benchmarking data to optimize outcomes in the complex field of musculoskeletal tumor surgery.
本研究调查了肌肉骨骼肿瘤手术术后并发症的相关危险因素,并评估了基准化对标在改善手术结果方面的影响。本回顾性分析在一家三级转诊中心进行,纳入了196例接受各种肌肉骨骼肿瘤手术的患者,范围从软组织肿瘤到骨肉瘤。使用查尔森合并症指数和Clavien-Dindo分类法对患者和肿瘤特征以及手术干预措施和结果进行了全面评估。主要研究结果表明,手术重建、美国麻醉医师协会(ASA)3级状态、骨肿瘤的存在以及多次红细胞输血的需求会显著增加术后发病率。值得注意的是,未发现查尔森合并症指数评分与并发症的发生或严重程度之间存在显著相关性,这对该指数在预测短期手术结果方面的效用提出了质疑。本研究强调了量身定制手术方法的重要性,并强调进行严格的术前评估以降低风险并改善患者护理。尽管本研究有其见解,但局限性包括其回顾性性质和单中心范围,这表明需要进行更广泛的多中心研究以推广研究结果。总体而言,我们的结果强调了将临床评估与基准化对标数据相结合以优化肌肉骨骼肿瘤手术这一复杂领域手术结果的必要性。