Resultados posquirúrgicos con el uso del sistema de sellado de vasos ultrasónico en cirugía de sarcomas de tejidos blandos en las extremidades. Estudio de cohorte longitudinal

Abstract

Background

Limbs soft tissue sarcomas have an incidence of 4.7 cases per 100,000 inhabitants and their surgical management has a high rate of morbidity and mortality due to bleeding. Use of ultrasonic vessel sealing is a novel technique often required. The aim of the study is to determine whether the intraoperative and postoperative results can be improve with the use of ultrasonic vessel sealing systems when surgeons are performing resection surgery of soft tissue sarcomas.

Methods

A longitudinal cohort was conducted between May 2017 and December 2018, including all patients undergoing resection of soft tissue sarcomas using ultrasonic vessel sealing technology that presented intraoperative and postoperative complications. The variables of age, sex, municipality, neighborhood, occupation, preoperative hemoglobin, intraoperative bleeding, hemovac drainage, postsurgical hemoglobin, seroma, hematoma, need for blood transfusion, and major complications were recorded. Data were analyzed using Shapiro Wilk or Kolmogorov Smirnov for descriptive statistics. Hypothesis tests to compare the occurrence of certain characteristics by stage or severity of the tumor pathology were performed using the Chi2 test or Fisher's test in qualitative variables, while the quantitative ones with t Student or Mann Whitney, a value of p < 0.05 it was considered statistically significant.

Results

32 patients were included in the study: 13 women and 19 men; the main types of sarcomas found were spindle cell sarcoma in 11 cases and liposarcoma in 5 cases. A median hemoglobin difference of −1.85 g/dL was found. The use of the ultrasonic bipolar vessel sealing system showed a 71% success rate for surgeries; complications occurred in 12% of patients.

Discussion

Ultrasonic vessel sealing system is a valid alternative that benefits limbs soft tissue sarcomas resection patient surgery by reducing surgery time and improving safer hemostasis. Further randomized controlled studies should be preformed.

Level of evidence: IV