Preoperative embolization of primary bone tumors: A case control study

Abstract

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 Case Control Study ORIGINAL ARTICLEsurgical 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.

Comparison of the WALANT and the PFNB techniques in the surgical treatment of unimalleolar fractures: a prospective study

“…One of the parameters that we considered in our research was the amount of bleeding. In a study by Jha et al, measurements was made by weighing bloody gauze to estimate the amount of bleeding (20). However, since there was not a lot of blood loss in our research, we preferred the method we described earlier (13).…”

Preoperative Embolization of a Delayed Femoral Metastasis of Renal Cell Carcinoma: A Case Report

“…Since preoperative embolization was first introduced in 1975, it has been shown to decrease intraoperative bleeding, allowing for decreased rates of required blood transfusion and better surgical outcomes [13]. Bone tumors that are often aided by preoperative embolization are commonly hypervascular, such as giant cell and renal cell tumors [13]. A successful preoperative embolization is the reduction of >70% of the vascularization, performed within 72 hours of surgery [6].…”

“…A successful preoperative embolization is the reduction of >70% of the vascularization, performed within 72 hours of surgery [6]. A case-control study conducted in 2016 reported a less amount of intraoperative blood loss and blood transfusion requirements in patients who received a preoperative embolization procedure for a primary bone tumor versus those that did not [13]. Geraets et al performed a systematic review that showed supporting evidence for preoperative embolization of RCC metastasis but not those from other primary tumors, including thyroid metastasis [6].…”

Pre-operative spine embolisation for spinal tumors and metastases: 6 years experience at pusat perubatan universiti kebangsaan Malaysia.

“…It was published by Roshan Jha et al in 2016 comparing 26 patients who underwent pre-operative embolisation with 28 patients in the control group (without pre-embolisation). The mean estimated blood loss (EBL) for the pre-embolised group was 1300ml and the non-embolised group was 1800ml 20 . Table 4 showed comparison of estimated and mean blood loss from our study in comparison with other studies from literature reviews .…”