文章：

瘤内流空直径作为预测转移性脊柱肿瘤姑息性切除手术中高术中失血的指标

Intratumoral Flow Void Diameter as a Predictor of High Intraoperative Blood Loss in Palliative Excisional Surgery for Metastatic Spinal Tumors

原文发布日期：10 December 2024

DOI: 10.3390/cancers16244124

类型: Article

开放获取: 是

英文摘要：

Background/Objectives:Massive intraoperative blood loss (IBL) is one of the major complications in metastatic spinal tumor surgery (MSTS), and understanding the predictors of this risk is essential. This study aimed to determine the impact of the intratumoral flow void (IFV) observed on standard magnetic resonance imaging (MRI) and its association with IBL in palliative surgery for metastatic spinal tumors.Methods:This retrospective analysis included 88 palliative excisional surgeries performed at a single hospital between 2010 and 2024. Factors such as age, sex, body mass index, tumor location, histological tumor type, spinal instability neoplastic score, revised Tokuhashi score, preoperative radiation, presence of IFV, and IFV diameter were assessed in addition to surgical details such as the number of resected and instrumented vertebrae and surgical duration.Results:Of the 88 patients, 71 (80.7%) exhibited IFV, with a mean IFV diameter of 1.8 ± 1.3 mm. The univariate analysis identified a significant association between IBL and several factors, including the presence of IFV, IFV diameter, hypervascular tumor type, number of instrumented vertebrae, and surgical duration. The multivariate analysis indicated that IFV diameter had the highest standardized coefficient among the examined variables, suggesting its strong potential as a predictor of IBL.Conclusions:This is the first study to identify the IFV diameter as a critical and independent predictor of IBL in MSTS. IFV diameter, which can be easily assessed using standard MRI, should be considered in surgical planning to effectively manage bleeding.

摘要翻译： 

背景/目的：术中大量失血是转移性脊柱肿瘤手术的主要并发症之一，了解其风险预测因素至关重要。本研究旨在探讨标准磁共振成像中观察到的瘤内流空信号及其与转移性脊柱肿瘤姑息性手术中术中失血量的关联。方法：本回顾性分析纳入了2010年至2024年间在一家医院进行的88例姑息性切除手术。除手术细节（如切除和固定椎体数量、手术时长）外，还评估了年龄、性别、体重指数、肿瘤位置、肿瘤组织学类型、脊柱肿瘤不稳定评分、修订版Tokuhashi评分、术前放疗、瘤内流空信号的存在及其直径等因素。结果：在88例患者中，71例（80.7%）存在瘤内流空信号，平均直径为1.8 ± 1.3毫米。单变量分析显示，术中失血量与多个因素显著相关，包括瘤内流空信号的存在、其直径、富血管肿瘤类型、固定椎体数量和手术时长。多变量分析表明，在所有考察变量中，瘤内流空信号直径的标准化系数最高，提示其作为术中失血量预测指标的潜力较强。结论：本研究首次确定瘤内流空信号直径是转移性脊柱肿瘤手术中术中失血量的关键独立预测因素。该指标可通过标准磁共振成像轻松评估，应在手术规划中予以考虑，以有效管理出血风险。

原文链接：

Intratumoral Flow Void Diameter as a Predictor of High Intraoperative Blood Loss in Palliative Excisional Surgery for Metastatic Spinal Tumors