Level-adjusted perioperative risk of sacral amputations

Clinton Devin, Paul Y. Chong, Ginger E. Holt, Irene Feurer, Adriana Gonzalez, Nipun Merchant, Herbert S. Schwartz

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background and Objectives: Sacral amputations above the S2 body often involve increased surgical complexity leading to long-term morbidity. The purpose of this study was to determine whether proximal sacral amputations have substantially higher perioperative morbidity compared with more distal sacral amputations. Methods: We evaluated the effect of sacral amputation level on perioperative outcomes within 90 days of surgery. Outcome measures included blood loss, intensive care unit (ICU) and hospital stay, hospital cost, and incidence of a major and minor morbidity. Survival analyses were adjusted for the level of resection and histological appearance. Results: Thirteen proximal and 14 distal resections were performed. In comparing proximal versus distal resections, median estimated blood loss was 4 L versus 1 L (P < 0.001), ICU stay was 4 days versus 0 days (P = 0.012), hospital stay was 19 days versus 8 days (P = 0.001), hospital cost was $28,800 versus $7,500 (P = 0.003), with one or more major complications in 85% versus 29% (P = 0.011). Survival analysis demonstrated that the sacral resection level did not influence survival (P = 0.936), whereas the type of tumor did influence survival (P = 0.012). Conclusion: Tumor resections above S2 demonstrate increased perioperative morbidity, suggesting that proximal osteotomies be reserved for patients with a realistic cure potential.

Original languageEnglish (US)
Pages (from-to)203-211
Number of pages9
JournalJournal of Surgical Oncology
Volume94
Issue number3
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

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Amputation
Morbidity
Hospital Costs
Survival Analysis
Intensive Care Units
Length of Stay
Survival
Osteotomy
Ambulatory Surgical Procedures
Neoplasms
Outcome Assessment (Health Care)
Incidence

Keywords

  • Acute morbidity
  • Chordoma
  • Perioperative morbidity
  • Sacrectomy
  • Sacrum

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Devin, C., Chong, P. Y., Holt, G. E., Feurer, I., Gonzalez, A., Merchant, N., & Schwartz, H. S. (2006). Level-adjusted perioperative risk of sacral amputations. Journal of Surgical Oncology, 94(3), 203-211. https://doi.org/10.1002/jso.20477

Level-adjusted perioperative risk of sacral amputations. / Devin, Clinton; Chong, Paul Y.; Holt, Ginger E.; Feurer, Irene; Gonzalez, Adriana; Merchant, Nipun; Schwartz, Herbert S.

In: Journal of Surgical Oncology, Vol. 94, No. 3, 01.09.2006, p. 203-211.

Research output: Contribution to journalArticle

Devin, C, Chong, PY, Holt, GE, Feurer, I, Gonzalez, A, Merchant, N & Schwartz, HS 2006, 'Level-adjusted perioperative risk of sacral amputations', Journal of Surgical Oncology, vol. 94, no. 3, pp. 203-211. https://doi.org/10.1002/jso.20477
Devin C, Chong PY, Holt GE, Feurer I, Gonzalez A, Merchant N et al. Level-adjusted perioperative risk of sacral amputations. Journal of Surgical Oncology. 2006 Sep 1;94(3):203-211. https://doi.org/10.1002/jso.20477
Devin, Clinton ; Chong, Paul Y. ; Holt, Ginger E. ; Feurer, Irene ; Gonzalez, Adriana ; Merchant, Nipun ; Schwartz, Herbert S. / Level-adjusted perioperative risk of sacral amputations. In: Journal of Surgical Oncology. 2006 ; Vol. 94, No. 3. pp. 203-211.
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