Published online Apr 28, 2016. doi: 10.4329/wjr.v8.i4.378
Peer-review started: September 12, 2015
First decision: October 8, 2015
Revised: December 24, 2015
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: April 28, 2016
Processing time: 222 Days and 19.1 Hours
AIM: To study the safety and effectiveness of preoperative embolization of primary bone tumors in relation to intraoperative blood loss, intraoperative blood transfusion volume and surgical time.
METHODS: Thirty-three patients underwent preoperative embolization of primary tumors of extremities, hip or vertebrae before resection and stabilization. The primary osseous tumors included giant cell tumors, aneurysmal bone cyst, osteoblastoma, chondroblastoma and chondrosarcoma. Twenty-six patients were included for the statistical analysis (embolization group) as they were operated within 0-48 h within preoperative embolization. A control group (non-embolization group, n = 28) with bone tumor having similar histological diagnosis and operated without embolization was retrieved from hospital record for statistical comparison.
RESULTS: The mean intraoperative blood loss was 1300 mL (250-2900 mL), the mean intraoperative blood transfusion was 700 mL (0-1400 mL) and the mean surgical time was 221 ± 76.7 min for embolization group (group I, n = 26). Non-embolization group (group II, n = 28), the mean intraoperative blood loss was 1800 mL (800-6000 mL), the mean intraoperative blood transfusion was 1400 mL (700-8400 mL) and the mean surgical time was 250 ± 69.7 min. On comparison, statistically significant (P < 0.001) difference was found between embolisation group and non-embolisation group for the amount of blood loss and requirement of blood transfusion. There was no statistical difference between the two groups for the surgical time. No patients developed any angiography or embolization related complications.
CONCLUSION: Preoperative embolization of bone tumors is a safe and effective adjunct to the surgical management of primary bone tumors that leads to reduction in intraoperative blood loss and blood transfusion volume.
Core tip: The current study shows that the preoperative embolisation of bone tumors performed 48 h prior to either limb salvage surgery or spinal stabilization leads to decrease in intraoperative blood loss and intraoperative blood transfusion volume. Therefore, would recommend that pre-operative embolisation is a safe procedure and should be used as part of the multi-disciplinary approach to the management of bone tumours in difficult anatomical locations especially those are known to be highly vascular.