Unplanned reoperation after resection of retroperitoneal sarcoma: experience based on a high-volume sarcoma center

• Published in: World journal of surgical oncology Vol. 20; no. 1; p. 158
• Main Authors: Zhuang, Aobo, Zhao, Mingkun, Fang, Yuan, Ma, Lijie, Lu, Weiqi, Zhou, Yuhong, Zhang, Yong, Tong, Hanxing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.05.2022; BioMed Central; BMC
• Subjects: Abdomen; Anastomosis; Care and treatment; China; Complications; Complications and side effects; Ewings sarcoma; Excision (Surgery); Female; Fistula; Gastric cancer; Hemorrhage; Hospitals; Humans; Intestine; Liposarcoma; Male; Middle Aged; Neoplasm Recurrence, Local - surgery; Organs; Pancreaticoduodenectomy; Patients; Postoperative; Public health; Quality indicator; Reoperation; Retroperitoneal Neoplasms - surgery; Retroperitoneal sarcoma; Retrospective Studies; Sarcoma; Sarcoma - surgery; Soft Tissue Neoplasms - surgery; Surgery; Surgical outcomes; Survival analysis; Survival Rate; Trauma; Tumors; Unplanned reoperation; China; Retroperitoneal sarcoma; Unplanned reoperation; Surgery; Quality indicator
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-022-02633-y

Most retroperitoneal sarcoma (RPS) operations require combined multi-organ resection, and the proportion of unplanned reoperation is high. However, there are no relevant studies on reoperation for RPS. Patients who underwent at least once unplanned reoperation at Shanghai Public Health Clinical Center, Fudan University, China, from August 2009 to December 2021 were retrospectively analyzed. The baseline characteristics, primary surgery, and reoperation information, postoperative complications, and survival were analyzed. A total of 51 patients were included. Among them, 21 (41.2%) were male and 30 (58.8%) were female. The median age was 51 (interquartile range [IQR], 49-63) years. Most (88.3%) had a history of abdominal surgery. Dedifferentiated liposarcoma, well-differentiated liposarcoma, leiomyosarcoma, and others accounted for 50.9%, 21.6%, 15.7%, and 11.8%, respectively. The conditions of the primary operation were as follows: 35 (68.6%) patients achieved complete surgical resection, 48 patients had combined organ resection, and a median of 3 (IQR, 2-4) organs was removed, of which 5 (9.9%) were combined with pancreaticoduodenectomy. The median operative time was 330 (IQR, 245-440) min, and the median estimated blood loss was 1500 (IQR, 500-2600) ml. The median postoperative hospital stay was 42 (IQR, 23-82) days. For reoperation, the most common reasons were bleeding (31.3%), complications related to intestinal anastomosis (27.4%), and intestinal perforation (19.9%). The mortality rate after reoperation was 39.2% (20/51). Twelve (23.5%) patients underwent reoperation at least twice. Unplanned reoperation among retroperitoneal sarcoma correlates with established measures of surgical quality.