Koichi Ogura1, Patrick J Boland1, Nicola Fabbri1, John H Healey2. 1. Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA. 2. Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA. Affiliated with Weill Medical College of Cornell University, New York, New York, USA.
Abstract
AIMS: Although internal hemipelvectomy is associated with a high incidence of morbidity, especially wound complications, few studies have examined rates of wound complications in these patients or have identified factors associated with the consequences. The present study aimed to: 1) determine the rate of wound and other complications requiring surgery after internal hemipelvectomy; and 2) identify factors that affect the rate of wound complications and can be used to stratify patients by risk of wound complications. METHODS: The medical records of 123 patients undergoing internal hemipelvectomy were retrospectively reviewed, with a focus on both overall complications and wound complications. Logistic regression analyses were performed to examine the association between host, tumour, and surgical factors and rates of postoperative wound complications. RESULTS: The overall rate of postoperative complications requiring surgery was 49.6%. Wound complications were observed in 34.1% of patients, hardware-related complications in 13.2%, graft-related complications in 9.1%, and local recurrence in 5.7%. On multivariate analysis, extrapelvic tumour extension (odds ratio (OR) 23.28; 95% confidence interval (CI), 1.97 to 274.67; p = 0.012), both intra- and extrapelvic tumour extension (OR 46.48; 95% CI, 3.50 to 617.77; p = 0.004), blood transfusion ≥ 20 units (OR 50.28; 95% CI, 1.63 to 1550.32; p = 0.025), vascular sacrifice of the internal iliac artery (OR 64.56; 95% CI, 6.33 to 658.43; p < 0.001), and use of a structural allograft (OR, 6.57; 95% CI, 1.70 to 25.34; p = 0.001) were significantly associated with postoperative wound complications. CONCLUSION: Internal hemipelvectomy is associated with high rates of morbidity, especially wound complications. Several host, tumour, and surgical variables are associated with wound complications. The ability to stratify patients by risk of wound complications can help refine surgical and wound-healing planning and may lead to better outcomes in patients undergoing internal hemipelvectomy. Cite this article: Bone Joint J 2020;102-B(3):280-284.
AIMS: Although internal hemipelvectomy is associated with a high incidence of morbidity, especially wound complications, few studies have examined rates of wound complications in these patients or have identified factors associated with the consequences. The present study aimed to: 1) determine the rate of wound and other complications requiring surgery after internal hemipelvectomy; and 2) identify factors that affect the rate of wound complications and can be used to stratify patients by risk of wound complications. METHODS: The medical records of 123 patients undergoing internal hemipelvectomy were retrospectively reviewed, with a focus on both overall complications and wound complications. Logistic regression analyses were performed to examine the association between host, tumour, and surgical factors and rates of postoperative wound complications. RESULTS: The overall rate of postoperative complications requiring surgery was 49.6%. Wound complications were observed in 34.1% of patients, hardware-related complications in 13.2%, graft-related complications in 9.1%, and local recurrence in 5.7%. On multivariate analysis, extrapelvic tumour extension (odds ratio (OR) 23.28; 95% confidence interval (CI), 1.97 to 274.67; p = 0.012), both intra- and extrapelvic tumour extension (OR 46.48; 95% CI, 3.50 to 617.77; p = 0.004), blood transfusion ≥ 20 units (OR 50.28; 95% CI, 1.63 to 1550.32; p = 0.025), vascular sacrifice of the internal iliac artery (OR 64.56; 95% CI, 6.33 to 658.43; p < 0.001), and use of a structural allograft (OR, 6.57; 95% CI, 1.70 to 25.34; p = 0.001) were significantly associated with postoperative wound complications. CONCLUSION: Internal hemipelvectomy is associated with high rates of morbidity, especially wound complications. Several host, tumour, and surgical variables are associated with wound complications. The ability to stratify patients by risk of wound complications can help refine surgical and wound-healing planning and may lead to better outcomes in patients undergoing internal hemipelvectomy. Cite this article: Bone Joint J 2020;102-B(3):280-284.
Authors: J Sybil Biermann; Warren Chow; Damon R Reed; David Lucas; Douglas R Adkins; Mark Agulnik; Robert S Benjamin; Brian Brigman; G Thomas Budd; William T Curry; Aarati Didwania; Nicola Fabbri; Francis J Hornicek; Joseph B Kuechle; Dieter Lindskog; Joel Mayerson; Sean V McGarry; Lynn Million; Carol D Morris; Sujana Movva; Richard J O'Donnell; R Lor Randall; Peter Rose; Victor M Santana; Robert L Satcher; Herbert Schwartz; Herrick J Siegel; Katherine Thornton; Victor Villalobos; Mary Anne Bergman; Jillian L Scavone Journal: J Natl Compr Canc Netw Date: 2017-02 Impact factor: 11.908
Authors: Alexander L Lazarides; Zachary D C Burke; Manit K Gundavda; Rostislav Novak; Michelle Ghert; David A Wilson; Peter S Rose; Philip Wong; Anthony M Griffin; Peter C Ferguson; Jay S Wunder; Matthew T Houdek; Kim M Tsoi Journal: Cancers (Basel) Date: 2022-04-27 Impact factor: 6.575
Authors: Mustafa Onur Karaca; Emre Anıl Özbek; Mustafa Özyıldıran; Abdullah Merter; Kerem Başarır; Hüseyin Yusuf Yıldız; Yener Sağlık Journal: Jt Dis Relat Surg Date: 2022-03-28