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摘要:
目的 建立骨与软组织肿瘤手术并发症分级系统,并进行初步临床验证。 方法 选取2011年8月至2016年12月在复旦大学附属肿瘤医院治疗的6 120例患者进行回顾性分析,参考Clavien-Dindo手术并发症分级系统进行分级,了解该分级系统的实用价值并验证其是否易于操作。 结果 Clavien-Dindo手术并发症分级系统结合具体示例应用于骨与软组织肿瘤手术能较为客观地反映不同干预措施的复杂程度及对患者的损害严重性,并发症的发生与否及分级高低与肿瘤切除和重建手术的复杂程度显著相关。在6 120例手术治疗患者中,1 136/6 120例(18.56%)接受了复杂的重建,总体手术并发症发生率为8.45%,3级以上并发症发生率为0.20%(12/6120),且这些患者均进行了重建。心肺脑血管意外死亡5例,无手术直接死亡。 结论 Clavien Dindo手术并发症分级系统结合具体示例可初步应用于骨与软组织肿瘤的外科评价,复杂的手术更易于发生并发症。尚需要进一步的研究以了解手术并发症的风险因素并提出改进建议。 Abstract:Objectives To establish a grading system of surgical complications for musculoskeletal tumors and to assess the accuracy of its preliminary application. Methods A total of 6, 120 patients with musculoskeletal tumors admitted for surgical therapy in Department of Musculoskeletal Oncology, Fudan University Cancer Center between August 2011 and December 2016 were retrospectively reviewed. The surgical complications were graded according to the Clavien- Dindo system. Results Data were obtained objectively in charts. Of the 6, 120 patients who underwent surgery, the overall complication rate was only 8.4%, although complicated reconstruction was performed in 1, 136/6, 120 (18.6%) cases. Grade 3 or more severe surgical complications were observed in only 38/6, 120 (0.62%) patients, all of whom underwent complicated reconstruction. Cardiopulmonary cerebral-associated death occurred in 5 cases. Conclusions The 5-grade system of surgical complications might be an applicable tool in evaluating surgical quality in the treatment of musculoskeletal tumors. Complications were more prone to occur in complicated surgeries. Further studies are needed to investigate the risk factors and to decrease the occurrence rate in patients with high risks. -
Key words:
- musculoskeletal tumor /
- surgery /
- complication /
- grade
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表 1 Clavien-Dindo手术并发症分级在骨与软组织肿瘤中的应用
表 2 骨与软组织肿瘤不同级别手术并发症的临床示例
表 3 6 120例骨与软组织肿瘤患者的临床病理资料
表 4 骨与软组织肿瘤患者应用手术并发症分级的结果
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