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首页> 外文期刊>Journal of Surgical Oncology >Level-adjusted perioperative risk of sacral amputations.
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Level-adjusted perioperative risk of sacral amputations.

机译：调整水平的围手术期risk骨截肢的风险。

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BACKGROUND AND OBJECTIVES: Sacral amputations above the S2 body often involve increased surgical complexity leading to long-term morbidity. The purpose of this study was to determine whether proximal sacral amputations have substantially higher perioperative morbidity compared with more distal sacral amputations. METHODS: We evaluated the effect of sacral amputation level on perioperative outcomes within 90 days of surgery. Outcome measures included blood loss, intensive care unit (ICU) and hospital stay, hospital cost, and incidence of a major and minor morbidity. Survival analyses were adjusted for the level of resection and histological appearance. RESULTS: Thirteen proximal and 14 distal resections were performed. In comparing proximal versus distal resections, median estimated blood loss was 4 L versus 1 L (P < 0.001), ICU stay was 4 days versus 0 days (P = 0.012), hospital stay was 19 days versus 8 days (P 0.001), hospital cost was 28,800 dollars versus 7,500 dollars (P 0.003), with one or more major complications in 85% versus 29% (P = 0.011). Survival analysis demonstrated that the sacral resection level did not influence survival (P = 0.936), whereas the type of tumor did influence survival (P = 0.012). CONCLUSION: Tumor resections above S2 demonstrate increased perioperative morbidity, suggesting that proximal osteotomies be reserved for patients with a realistic cure potential.
机译：背景和目的：S2体上方的S骨截肢术通常涉及增加手术复杂性，从而导致长期发病。这项研究的目的是确定与远端distal骨截肢术相比，proximal骨近端截肢术是否具有更高的围手术期发病率。方法：我们评估了90骨截肢水平对手术90天内围手术期效果的影响。结果指标包括失血，重症监护病房（ICU）和住院时间，住院费用以及主要和次要发病率。调整生存分析的切除水平和组织学外观。结果：进行了13个近端切除和14个远端切除。在比较近端切除术和远端切除术时，中位估计失血量为4 L对1 L（P <0.001），ICU停留时间为4天vs 0天（P = 0.012），住院时间为19天vs 8天（P 0.001），住院费用为28,800美元，而同期为7,500美元（P = 0.003），其中一种或多种主要并发症的发生率分别为85％和29％（P = 0.011）。生存分析表明the骨切除水平不影响生存（P = 0.936），而肿瘤类型确实影响生存（P = 0.012）。结论：S2以上的肿瘤切除术表明围手术期发病率增加，这表明近端截骨术应保留给具有实际治愈潜力的患者。

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