Abstract

Background

Soft tissue sarcomas arise in the deep sites of the buttocks and lower extremities. Since a tourniquet is not applied during surgery for soft tissue sarcomas at such sites, excessive intraoperative blood loss may occur. Various devices, including LigaSure™ (Medtronic, Dublin, Ireland), are used as electrothermal bipolar vessel sealers. However, its clinical relevance in soft tissue sarcomas surgery remains unclear. This study aimed to assess the effectiveness of LigaSure™ in soft tissue sarcomas surgery.

Methods

This study included 168 patients who underwent surgeries for soft tissue sarcomas in the deep sites in the buttocks and lower extremities between January 2004 and March 2018. The primary outcome was intraoperative blood loss, and secondary outcomes were surgery duration, wound complications, perioperative haemoglobin concentrations and intraoperative blood transfusion. To reduce selection biases, propensity score matching was applied. We defined the matched cases wherein LigaSure™ was used as the ‘using group’ and the other matched cases as the ‘non-using group’. Outcomes were compared between both groups.

Results

From each group, 35 cases were selected using propensity score matching. The intraoperative blood loss was significantly smaller statistically in the using group (181.5 ± 240.4 ml vs. 394.7 ± 547.3 ml, respectively; P = 0.041). The duration of operation was longer in the using group (189.9 ± 97.6 min vs. 140.6 ± 75.7 min, respectively; P = 0.007). There were no significant differences in other outcomes.

Conclusion

By using LigaSure™ for soft tissue sarcomas occurring in the buttocks and lower extremities, we observed a trade-off between reduced intraoperative blood loss and longer operative time.

中文翻译：

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软组织肉瘤手术期间血管封闭系统 (LigaSure™) 的临床益处：倾向评分匹配分析

摘要

背景

软组织肉瘤出现在臀部和下肢的深部。由于这些部位的软组织肉瘤在手术过程中没有使用止血带，因此可能会出现术中失血过多。各种设备，包括 LigaSure™（美敦力，都柏林，爱尔兰），被用作电热双极容器密封剂。然而，其在软组织肉瘤手术中的临床相关性仍不清楚。本研究旨在评估 LigaSure™ 在软组织肉瘤手术中的有效性。

方法

本研究纳入 168 名在 2004 年 1 月至 2018 年 3 月期间接受臀部和下肢深部软组织肉瘤手术的患者。主要结果是术中失血量，次要结果是手术持续时间、伤口并发症、围手术期血红蛋白浓度和术中输血。为了减少选择偏差，应用了倾向评分匹配。我们将使用 LigaSure™ 的匹配案例定义为“使用组”，将其他匹配的案例定义为“未使用组”。比较两组的结果。

结果

从每组中，使用倾向评分匹配选择了 35 例。使用组的术中失血量在统计学上显着减少（分别为 181.5 ± 240.4 ml 和 394.7 ± 547.3 ml；P = 0.041）。使用组的手术持续时间更长（分别为 189.9 ± 97.6 分钟和 140.6 ± 75.7 分钟；P = 0.007）。其他结果没有显着差异。

结论

通过使用 LigaSure™ 治疗发生在臀部和下肢的软组织肉瘤，我们观察到了减少术中失血和延长手术时间之间的权衡。