Blood loss and transfusion associated with musculoskeletal tumor surgery

2005 ◽  
Vol 92 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Akira Kawai ◽  
Hiroaki Kadota ◽  
Umio Yamaguchi ◽  
Yuki Morimoto ◽  
Toshifumi Ozaki ◽  
...  
Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4384-4384
Author(s):  
Philip A Thompson ◽  
Deborah May ◽  
Peter Choong ◽  
Scott McArdle ◽  
Mary Gaskell ◽  
...  

Abstract Abstract 4384 The management of musculoskeletal tumors has evolved markedly over the past 30 years, with improvements in surgical techniques, staging and chemotherapeutic advances delivering improved survival and functional outcomes, both in the setting of primary malignant bone tumors and in the palliation of tumors metastatic to bone. Advances in surgical technique as well as pre-operative chemotherapy has meant that most patients are now able to undergo limb-sparing surgery. Whilst clearly desirable to improve functional outcome, limb-sparing surgery is however more technically challenging and is associated with greater blood loss than amputation. There is a paucity of data concerning blood utilization in the setting of major musculoskeletal tumor surgery. We retrospectively analyzed a database containing 1322 consecutive surgeries in 1222 patients over a 14 year timeframe, performed at a quaternary referral center in Melbourne, Australia. The following factors were significantly associated with high blood utilization: Chordomas, sacral and pelvic tumors, lower starting haemoglobin, tumors >5cm in size and high American Society of Anesthesiologists (ASA) score. The ASA score also clearly correlated with 30 day mortality. Pre-operative planning in these patients is critical to ensure adequate blood supply, minimize wastage and optimize the patient's general health prior to surgery. As such, based on modeling from our data, we propose a maximum surgical blood order schedule based on the presence or absence of the above factors. Allogeneic blood transfusion, while a potentially life-saving intervention, is associated with major complications, including transmission of infectious agents and immunological complications. Longer-term, transfusion has been reported to result in immunomodulation and potentially a higher risk of tumor recurrence. Clearly, minimization of blood loss and avoidance of un-necessary transfusion is desirable. There is also a lack of data surrounding interventions designed to minimize blood loss in musculoskeletal tumor surgery, especially when compared to similar studies performed in major orthopedic surgery for benign conditions. These would be ideal targets for future randomized studies in the high-risk groups we have identified. Disclosures: No relevant conflicts of interest to declare.


2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 9052-9052
Author(s):  
A. Kawai ◽  
H. Kadota ◽  
U. Yamaguchi ◽  
Y. Morimoto ◽  
M. Endo ◽  
...  

2020 ◽  
Vol 4 (3) ◽  
pp. 141
Author(s):  
Mutlaq Almutlaq ◽  
Wazzan Aljuhani ◽  
Abdulrahman Alomar ◽  
Khalid Alanazi ◽  
AbdullahS Al-Thani ◽  
...  

2019 ◽  
Vol 10 (04) ◽  
pp. 631-640 ◽  
Author(s):  
Vanitha Rajagopalan ◽  
Rajendra Singh Chouhan ◽  
Mihir Prakash Pandia ◽  
Ritesh Lamsal ◽  
Girija Prasad Rath

Abstract Background Major blood loss during neurosurgery can lead to several complications, including life-threatening hemodynamic instabilities. Studies addressing these complications in patients undergoing intracranial tumor surgery are limited. Materials and Methods During the study period, 456 patients who underwent elective craniotomy for brain tumor excision were categorized into four groups on the basis of estimated intraoperative blood volume loss: Group A (<20%), Group B (20–50%), Group C (>50–100%), and Group D (more than estimated blood volume). The occurrence of various perioperative complications was correlated with these groups to identify if there was any association with the amount of intraoperative blood loss. Results The average blood volume loss was 11% ± 5.3% in Group A, 29.8% ± 7.9% in Group B, 68.3% ± 13.5% in Group C, and 129.1% ± 23.9% in Group D. Variables identified as risk factors for intraoperative bleeding were female gender (p < 0.001), hypertension (p = 0.008), tumor size >5 cm (p < 0.001), high-grade glioma (p = 0.004), meningioma (p < 0.001), mass effect (p = 0.002), midline shift (p = 0.014), highly vascular tumors documented on preoperative imaging (p < 0.001), extended craniotomy approach (p = 0.002), intraoperative colloids use >1,000 mL (p < 0.001), intraoperative brain bulge (p = 0.03), intraoperative appearance as highly vascular tumor (p < 0.001), and duration of surgery >300 minutes (p < 0.001). Conclusions Knowledge of these predictors may help anesthesiologists anticipate major blood loss during brain tumor surgery and be prepared to mitigate these complications to improve patient outcome.


2013 ◽  
Vol 95 (18) ◽  
pp. 1684-1691 ◽  
Author(s):  
Koichi Ogura ◽  
Hideo Yasunaga ◽  
Hiromasa Horiguchi ◽  
Kazuhiko Ohe ◽  
Yusuke Shinoda ◽  
...  

Sarcoma ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Satoshi Nagano ◽  
Masahiro Yokouchi ◽  
Takao Setoguchi ◽  
Hiromi Sasaki ◽  
Hirofumi Shimada ◽  
...  

Surgical site infection (SSI) has not been extensively studied in musculoskeletal tumors (MST) owing to the rarity of the disease. We analyzed incidence and risk factors of SSI in MST. SSI incidence was evaluated in consecutive 457 MST cases (benign, 310 cases and malignant, 147 cases) treated at our institution. A detailed analysis of the clinical background of the patients, pre- and postoperative hematological data, and other factors that might be associated with SSI incidence was performed for malignant MST cases. SSI occurred in 0.32% and 12.2% of benign and malignant MST cases, respectively. The duration of the surgery (P=0.0002) and intraoperative blood loss (P=0.0005) was significantly more in the SSI group than in the non-SSI group. We established the musculoskeletal oncological surgery invasiveness (MOSI) index by combining 4 risk factors (blood loss, operation duration, preoperative chemotherapy, and the use of artificial materials). The MOSI index (0–4 points) score significantly correlated with the risk of SSI, as demonstrated by an SSI incidence of 38.5% in the group with a high score (3-4 points). The MOSI index score and laboratory data at 1 week after surgery could facilitate risk evaluation and prompt diagnosis of SSI.


2008 ◽  
Vol 467 (1) ◽  
pp. 239-245 ◽  
Author(s):  
Benjamin Tuy ◽  
Chinmoy Bhate ◽  
Kathleen Beebe ◽  
Francis Patterson ◽  
Joseph Benevenia

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