1
|
Bian Y, Xu Y, Xu Y, Li Z, Zhu W, Zhou X, Liu Y, Feng B, Chen B, Weng X. Surgical treatment for pelvic haemophilic pseudotumour: a retrospective analysis of 21 cases. EClinicalMedicine 2024; 69:102497. [PMID: 38435760 PMCID: PMC10907507 DOI: 10.1016/j.eclinm.2024.102497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Background Due to the rarity of pelvic haemophilic pseudotumour (PHPT) and demanding surgical technique for PHPT excision, no study reports the mid-term follow-up outcomes of surgical treatment of PHPT in a relatively large cohort. PHPT with varying degrees of bony pelvic involvement and infection status necessitates different operative procedures, yet there is currently no classification system for PHPT based on surgical practice. Methods The study was conducted between June 25, 2004 and July 18, 2023, in Peking Union Medical College Hospital and Nanfang Hospital in China. We performed a retrospective analysis involving 21 patients with 24 PHPTs with a mean follow-up period of 7.1 years. The demographic information, PHPT characteristics, surgical data, and perioperative complications were analysed. Findings 21 consecutive male patients with 24 PHPTs (21 primary PHPTs and three recurrent PHPTs) that underwent surgical treatment were involved in the study. A classification system including four subtypes was introduced as (I) PHPT confined to soft tissue; (II) PHPT involving bony pelvic without pelvic discontinuity; (III) PHPT causing pelvic discontinuity; (IV) Infectious PHPT. Of the 24 PHPTs, 11 (45.8%) were identified as Type I, five (20.8%) as Type II, three (12.5%) as Type III, and five (20.8%) as Type IV. At the time of surgery, the patients had a mean age of 37.0 ± 9.5 years (Range, 24-52 years). The mean maximum diameter of PHPTs upon surgery was 17.0 ± 7.7 cm (Range, 4.3-40.0 cm). The mean surgical duration was 192 ± 77 min (Range, 60-330 min) and the median intraoperative blood loss was 400 mL (IQR, 225-950 mL, Range, 100-3000 mL). One patient (4.8%) underwent intraoperative cardiopulmonary arrest and expired the following week. Four PHPTs (16.7%) presented postoperative wound infections and poor wound healing. During the follow-up period, five PHPTs (20.8%) experienced pseudotumour recurrence. Interpretation Our findings suggest that surgical treatment for PHPTs is feasible and relatively safe. Symptomatic and progressive PHPTs should undergo surgical intervention as early as possible to minimise the surgical risks. Intraoperative use of abundant gelatin sponges in PHPT excision draws attention to severe embolism complications. Funding There are no sources of funding for this manuscript.
Collapse
Affiliation(s)
- Yixin Bian
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| | - Yaowen Xu
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People’s Republic of China
| | - Yiming Xu
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| | - Ziquan Li
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| | - Wei Zhu
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| | - Xi Zhou
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| | - Yong Liu
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| | - Bin Feng
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| | - Bin Chen
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People’s Republic of China
| | - Xisheng Weng
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China
| |
Collapse
|
2
|
Kim MJ, Lee EH, Yoon HS. Successful Non-operative Management of Intra-abdominal Hemorrhage in Two Patients with Hemophilia A. CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2017. [DOI: 10.15264/cpho.2017.24.1.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mi Jin Kim
- Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Eun Hye Lee
- Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hoi Soo Yoon
- Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
| |
Collapse
|
3
|
Pennekamp PH, Strauss AC, Klein C, Marx A, Goldmann G, Friedrich M, Marquardt N, Oldenburg J. Giant haemophilic pseudotumour of the pelvis: case report and literature review. Haemophilia 2015; 21:e484-6. [DOI: 10.1111/hae.12752] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2015] [Indexed: 11/30/2022]
Affiliation(s)
- P. H. Pennekamp
- Department of Orthopaedics and Trauma Surgery; University of Bonn; Bonn Germany
| | - A. C. Strauss
- Department of Orthopaedics and Trauma Surgery; University of Bonn; Bonn Germany
| | - C. Klein
- Institute of Experimental Haematology and Transfusion Medicine; University of Bonn; Bonn Germany
| | - A. Marx
- Internal Medical Clinic I; University of Bonn; Bonn Germany
| | - G. Goldmann
- Institute of Experimental Haematology and Transfusion Medicine; University of Bonn; Bonn Germany
| | - M. Friedrich
- Department of Orthopaedics and Trauma Surgery; University of Bonn; Bonn Germany
| | - N. Marquardt
- Institute of Experimental Haematology and Transfusion Medicine; University of Bonn; Bonn Germany
| | - J. Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine; University of Bonn; Bonn Germany
| |
Collapse
|