骨与软组织肿瘤手术并发症分级系统与验证

中国抗癌协会肉瘤专业委员会软组织肉瘤与恶性黑色素瘤学组,  陈勇

downloadPDF
文章导航 > 中国肿瘤临床  > 2019 >  46(5): 228-232
中国抗癌协会肉瘤专业委员会软组织肉瘤与恶性黑色素瘤学组, 陈勇. 骨与软组织肿瘤手术并发症分级系统与验证[J]. 中国肿瘤临床, 2019, 46(5): 228-232. doi: 10.3969/j.issn.1000-8179.2019.05.088
引用本文: 中国抗癌协会肉瘤专业委员会软组织肉瘤与恶性黑色素瘤学组, 陈勇. 骨与软组织肿瘤手术并发症分级系统与验证[J]. 中国肿瘤临床, 2019, 46(5): 228-232. doi: 10.3969/j.issn.1000-8179.2019.05.088
shu
Soft Tissue Sarcoma and Melanoma Group of Sarcoma Committee, Chinese Anti-Cancer Association, Chen Yong. Grading system of surgical complications in musculoskeletal tumors and validation[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(5): 228-232. doi: 10.3969/j.issn.1000-8179.2019.05.088
Citation: Soft Tissue Sarcoma and Melanoma Group of Sarcoma Committee, Chinese Anti-Cancer Association, Chen Yong. Grading system of surgical complications in musculoskeletal tumors and validation[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(5): 228-232. doi: 10.3969/j.issn.1000-8179.2019.05.088
shu

骨与软组织肿瘤手术并发症分级系统与验证

doi: 10.3969/j.issn.1000-8179.2019.05.088
基金项目: 

国家自然科学基金项目 81302342

详细信息
    通讯作者:

    陈勇 chenyong@fudan.edu.cn

Grading system of surgical complications in musculoskeletal tumors and validation

Funds: 

the National Natural Science Foundation of China 81302342

More Information

    摘要
  • 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.

     

    • HTML全文

  • 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
    • 参考文献(11)
  • [1] Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy[J]. Surgery, 1992, 111:518-526. http://cn.bing.com/academic/profile?id=af34de37759fadaced48afa3027ef05b&encoded=0&v=paper_preview&mkt=zh-cn
    [2] Strasberg SM, Linehan DC, Hawkins WG. The accordion severity grading system of surgical complications[J]. Ann Surg, 2009, 250(2): 177-186. doi: 10.1097/SLA.0b013e3181afde41
    [3] Daniel D, Nicolas D, Pierre-Alain C. Classification of surgical complications a new proposal with evaluation in a cohort of 6336 patients and results of a survey[J]. Ann Surg, 2004, 240(2):205-213. doi: 10.1097/01.sla.0000133083.54934.ae
    [4] Martin RC, Brennan MF, Jaques DP. Quality of complication reporting in the surgical literature[J]. Ann Surg, 2002, 235(6):803-813. doi: 10.1097/00000658-200206000-00007
    [5] Moore J, Isler M, Barry J, et al. Major wound complication risk factors following soft tissue sarcoma resection[J]. Eur J Surg Oncol, 2014, 40(12):1671-1676 doi: 10.1016/j.ejso.2014.10.045
    [6] Bertero L, Massa F, Massa F, et al. Eighth edition of the UICC classification of malignant tumours: an overview of the changes in the pathological TNM classification criteria-what has changed and why[J]? Virchows Arch, 2018, 472(4):519-531. doi: 10.1007/s00428-017-2276-y
    [7] Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system[J]. Clin Orthop Relat Res, 1993, (286):241-246. http://cn.bing.com/academic/profile?id=205a2ec7d2dc2b722c2fd7371d4119a6&encoded=0&v=paper_preview&mkt=zh-cn
    [8] 中华人民共和国卫生部.卫生部办公厅关于印发医疗机构手术分级管理办法(试行)的通知[EB/OL].(2012- 08- 03).http://www.moh.gov.cn
    [9] Collins T, Daley J, Henderson W, et al. Risk factors for prolonged length of stay after major elective surgery[J]. Ann Surg, 1999, 230 (2):251-259. doi: 10.1097/00000658-199908000-00016
    [10] 胥少汀.骨科手术并发症预防与处理[M].第三版, 北京:人民军医出版社, 2010.
    [11] Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five- year experience[J]. Ann Surg, 2009, 250(2):187-196. doi: 10.1097/SLA.0b013e3181b13ca2
    • 相关文章
    • 施引文献
  • 资源附件(0)
  • 加载中
WeChat 点击查看大图
表(4)
计量
  • 文章访问数:  53
  • HTML全文浏览量:  3
  • PDF下载量:  4
  • 被引次数: 0
出版历程
  • 收稿日期:  2018-10-15
  • 修回日期:  2019-02-26
  • 刊出日期:  2019-05-15

目录

    /

    返回文章
    返回

    版权所有 © 2013《中国肿瘤临床》编辑部津ICP备09011441号-3

    地址：天津市河西区体院北环湖西路肿瘤医院内 300060电话/传真：(022)23527053Email：cjco@cjco.cn

    本系统由北京仁和汇智信息技术有限公司开发    百度统计