Effect of Electrosurgery on Blood Loss and Intraoperative Transfusions in Musculoskeletal Tumor Surgery
Study Details
Study Description
Brief Summary
Resection of malign musculoskeletal tumors and reconstruction with large tumor prostheses often results in relevant blood loss requiring hemodynamic stabilization and transfusion.
The use of novel electrosurgical electrodes is assessed retrospectively regarding the potential to reduce blood loss and the need for transfusions.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Background Resection of malign musculoskeletal tumors and reconstruction with large tumor prostheses often result in relevant blood loss requiring hemodynamic stabilization and transfusion. Since machine autotransfusion is contraindicated in tumor surgery, other measures are necessary to reduce intraoperative blood loss.
Objectives Tungsten needle electrodes can be used to simultaneously cut skin and seal bleeding vessels for superficial dissection. Spatula electrodes coated with Teflon (polytetrafluoroethylene PTFE) are used for coagulation and dissection of deeper tissues. The coating reduces eschar build-up and thus smoke creation compared to conventional stainless-steel electrodes. This study assesses the effect of these novel electrodes on blood loss and transfusion rates.
Methods:
The investigators retrospectively investigate all cases of tumor resection and reconstruction with tumor prostheses that were operated five years before the introduction of the new electrodes (2012-2016) and five years after (2018-2021) by one single surgeon with over 25 years of experience. Data are extracted from digital patient records and analyzed by descriptive statistics and t-test for normally distributed data or Mann-Whitney test in case of non-normal distribution.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Tungsten/Teflon + Dissection with novel electrodes (Tungsten needle electrode + Teflon coated Spatula electrode) |
Device: Application of novel electrodes
Application of novel electrodes since 2017 for the dissection of extremity tumors in tumororthopedics
|
| Tungsten/Teflon - Dissection without novel electrodes (Scalpel + Steel Spatula Electrode) |
Outcome Measures
Primary Outcome Measures
- Blood loss [during surgery]
monitored during surgery in the anaesthesiology protocol
- Transfusion of red packed blood cells [during surgery]
number of intraoperative units of packed red blood cells
- Transfusion of red packed blood cells [14 days post surgery]
number of intraoperative units of packed red blood cells
Secondary Outcome Measures
- post surgical wound drainage [5 days post surgey]
assessed via recorded volume
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients who received hemipelvectomy, hip disarticulation, or major tumor prosthesis implantation at our hospital between 2010 and 2021
-
Operated by one single surgeon
Exclusion Criteria:
- Implantation of a Megaprosthesis without history of tumor
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University Hospital Muenster | Münster | NRW | Germany | 48151 |
Sponsors and Collaborators
- University Hospital Muenster
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 202101