Inadvertent Inguinal Sarcoma Excision during Hernia Surgery: Outcomes, Gender Analysis, and Prevention.

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2020-12-07 eCollection Date: 2020-01-01 DOI:10.1155/2020/8374790
Joshua M Lawrenz, James P Norris, Marcus C Tan, Eric T Shinohara, John J Block, Elizabeth J Davis, Vicki L Keedy, Jennifer L Halpern, Ginger E Holt, Herbert S Schwartz
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引用次数: 2

Abstract

Introduction: Inadvertent excision of a soft tissue sarcoma during hernia surgery is a preventable clinical scenario that leads to unnecessary patient morbidity. Prior series are few, which only include male patients with little focus on prevention. The purpose of this study is to report the presenting features and outcomes of both male and female patients who underwent inadvertent inguinal sarcoma excision during hernia surgery.

Methods: A retrospective analysis of a single sarcoma referral center identified 33 patients who were referred for definitive treatment. Patients were divided into three clinically relevant groups based on intraoperative diagnosis, sex, and location of the mass relative to the inguinal ligament. T-tests and Fisher's exact tests were performed to compare continuous and categorical variables, respectively. Kaplan-Meier modeling was performed to assess sarcoma-specific survival.

Results: Females were younger (47 years vs. 61 years, p=0.003) and had smaller sarcomas (6.7 cm vs. 11 cm, p=0.012) compared to males. Only two sarcomas (2/33, 6%) were <4 cm in size. The majority of sarcomas in females were above the inguinal ligament (12/14, 86%). Twenty-nine (88%) underwent definitive R0 excision. The mean number of surgeries per patient was three (range 1-13), with nineteen (58%) patients requiring flap reconstruction and six (18%) requiring vascular bypass. Five patients locally recurred (15%) at a mean of 38 months after definitive excision (range 5-128 months). Overall sarcoma-specific disease-free survival was 64%, with no difference between males (80 ± 11%) and females (59 ± 17%) (p=0.885). Mean follow-up was 75 months (range 5-212).

Conclusion: This is the second largest study regarding inadvertent inguinal sarcoma excision and the first to include females. When a suspected hernia is >4 cm, irreducible, firm, and is growing, especially in females, consider obtaining preoperative advanced three-dimensional imaging (CT or MRI) that can differentiate a neoplasm from a hernia.

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疝气手术中不慎腹股沟肉瘤切除:结果、性别分析和预防。
简介:在疝气手术中不慎切除软组织肉瘤是一种可预防的临床情况,导致不必要的患者发病率。以前的系列很少,只包括男性患者,很少关注预防。本研究的目的是报告在疝手术中不慎切除腹股沟肉瘤的男性和女性患者的表现特征和结果。方法:回顾性分析单个肉瘤转诊中心确定了33例转诊患者进行最终治疗。根据术中诊断、性别和肿块相对于腹股沟韧带的位置,将患者分为三个临床相关组。分别进行t检验和Fisher精确检验来比较连续变量和分类变量。采用Kaplan-Meier模型评估肉瘤特异性生存。结果:与男性相比,女性更年轻(47岁对61岁,p=0.003),肉瘤更小(6.7 cm对11 cm, p=0.012)。只有2例肉瘤(2/ 33,6 %)p=0.885)。平均随访75个月(范围5-212)。结论:这是关于无意中腹股沟肉瘤切除的第二大研究,也是第一个包括女性的研究。当疑似疝> 4cm,不可缩小,坚固且正在生长时,尤其是女性,应考虑术前进行先进的三维成像(CT或MRI),以区分肿瘤和疝。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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