A retrospective chart review of 123 consecutive patients who underwent TCTs at a single academic referral center over a 10-year period was conducted. Surgical indication, corpectomy levels, intraoperative dural tears, pleural injuries, neurological injuries, 90-day mortality, 90-day reoperations, and hospital-based medical complications were evaluated.
One hundred twenty-three patients underwent a TCT, including 35 for infection, 42 for malignancy, 23 for trauma, and 23 for deformity. Fifty-nine patients (48.0%) had at least one medical or 90-day operative complication, with 22 patients (17.9%) having two or more complications. Patients with a diagnosis of infection were more likely to undergo two-level corpectomies (80% vs 26.1%, p < 0.0005). Patients with a diagnosis of malignancy had significantly higher 90-day mortality (19.0% vs 4.9%, p = 0.022) and were more likely to undergo three-level corpectomies (9.5% vs 3.7%, p = 0.002) and upper thoracic (T1-4) corpectomies (37.9% vs 12.4%, p = 0.001), and sustain a pleural injury (14.3% vs 2.5%, p = 0.019). Ninety-day reoperation rates (p = 0.970), postoperative ventilator days (p = 0.224), intensive care unit stays (p = 0.350), hospital lengths of stay (p = 0.094), neurological injuries (p = 0.338), and dural tears (p = 0.794) did not significantly vary between the different groups.
Nearly half of the patients undergoing a TCT will experience an unanticipated short-term complication related to the procedure. Short-term complications may vary with the underlying patient diagnosis.
方法:对在一个学术转诊中心进行10年的123例连续TCTs患者进行回顾性分析。手术适应症,全身切除术水平,术中硬脑膜撕裂,胸膜损伤,神经损伤,90天死亡率,90天的再手术,和以医院为基础的医疗并发症进行了评估。
结果:一百二十三例患者接受了TCT,包括35例感染,42为恶性肿瘤,23号外伤,和23畸形。59名患者(48.0%)至少有一次内科或90天手术并发症,22例患者(17.9%)有两个或两个以上的并发症。诊断为感染的患者更有可能进行两级皮质切除术(80%vs26.1%,p<0.0005)。诊断为恶性肿瘤的患者的90天死亡率明显更高(19.0%vs4.9%,p=0.022),并且更有可能进行三级皮质切除术(9.5%vs3.7%,p=0.002)和上胸部(T1-4)皮质切除术(37.9%vs12.4%,p=0.001),并维持胸膜损伤(14.3%vs2.5%,p=0.019)。90天再手术率(p=0.970),术后呼吸机天数(p=0.224),重症监护病房住院(p=0.350),住院时间(p=0.094),神经损伤(p=0.338),硬脑膜撕裂(p=0.794)在不同组之间没有显着差异。
结论:将近一半接受TCT的患者会经历与手术相关的意外短期并发症。短期并发症可能因患者的潜在诊断而异。