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Evaluation of blood loss during limb salvage surgery for pelvic tumours

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Abstract

As a large amount of blood loss is sometimes encountered in limb salvage procedures for pelvic tumours, it is essential to identify risk factors predicting the possibility of extensive haemorrhage. We retrospectively reviewed 137 patients who underwent pelvic tumour resections. Patients with an estimated blood loss greater than 3,000 ml were classified as having a large amount of blood loss. Sixty-one (44.53%) patients had blood loss greater than 3,000 ml. Tumours involving the acetabulum or sacrum, tumour volume greater than 400 cm3, aorta occlusion, resection method, reconstruction and operative time were all associated with a large amount of blood loss. Pelvic tumours involving the acetabulum or sacrum (odds ratio: 4.837), tumour volume greater than 400 cm3 (odds ratio: 3.005) and planned operation time of more than 200 min (odds ratio: 3.784) independently predicted a large amount of blood loss. Pelvic tumours with these characteristics were likely to have a large amount of blood loss during surgery.

Résumé

Très souvent, la perte sanguine est très importante dans le traitement des tumeurs pelviennes, il est donc essentiel d’identifier les facteurs de risques pouvant laisser penser qu’il y ait possibilité d’une hémorragie importante. Nous avons revu de façon rétrospective 137 patients présentant une tumeur du pelvis. Les patients qui avaient une perte sanguine estimée supérieure à 3 litres ont été classés comme patients présentant une perte sanguine importante. 61 (44,53%) ont eu une perte sanguine supérieure à 3 litres. Les tumeurs incluant le cotyle et le sacrum, les tumeurs dont le volume était supérieur à 400 cm3 avec des lésions au niveau de l’aorte nécessitant des gestes de résections et de reconstruction et un temps chirurgical important, tous ces facteurs sont associés à une importante perte sanguine. Dans les tumeurs incluant l’accétulum et le sacrum l’odds ratio est de 4,837, pour les tumeurs dont le volume est supérieur à 400 cm3, l’odds ratio est de 3,005, quand il est prévu une intervention dont le temps opératoire est supérieur à 200 minutes l’odds ratio 3,784. Les tumeurs pelviennes présentant toutes ces caractéristiques peuvent présenter de façon préférentielle d’importantes pertes sanguines durant la chirurgie.

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Contribution of authors

XT: main investigator, first and final draft. WG: conceived the study and reviewed the data analysis. RY, ST, TJ: co-investigators for data collection, first draft, and statistical analysis.

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Authors and Affiliations

  1. Musculoskeletal Tumor Center, People’s Hospital, Peking University, Beijing, 100044, People’s Republic of China

    Xiaodong Tang, Wei Guo, Rongli Yang, Shun Tang & Tao Ji

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  1. Xiaodong Tang
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  2. Wei Guo
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  3. Rongli Yang
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  4. Shun Tang
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  5. Tao Ji
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Correspondence to Wei Guo.

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Tang, X., Guo, W., Yang, R. et al. Evaluation of blood loss during limb salvage surgery for pelvic tumours. International Orthopaedics (SICOT) 33, 751–756 (2009). https://doi.org/10.1007/s00264-008-0695-8

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  • DOI: https://doi.org/10.1007/s00264-008-0695-8

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