Resección no planificada en sarcomas de partes blandas del aparato locomotor / Unplanned excision of soft tissue sarcomas of the musculoskeletal system

Introducción: El proceso diagnóstico de los sarcomas de partes blandas del aparato locomotor (SPBAL) sigue siendo comprometido, con casos de resecciones no planificadas (cirugías «whoops»). Este estudio evalúa la frecuencia de este tipo de procedimientos, tratando de identificar características de los pacientes, tumores, tratamiento quirúrgico y resultados. Material y métodos: Se revisan de forma retrospectiva 131 pacientes tratados de forma quirúrgica en nuestro centro entre octubre de 2018 y diciembre de 2021 de un SPBAL. Se excluyen los pacientes con SPBAL localizados en vísceras, mediastino, corazón, retroperitoneo, peritoneo y aparato genital. Las diferencias entre pacientes con resecciones planificadas y no planificadas fueron evaluadas con pruebas χ2 y un modelo de regresión multivariado de Cox. Resultados: Las resecciones no planificadas de SPBAL han tenido lugar en 18% de los pacientes de nuestra área, principalmente en tumores menos de 5 cm y localizados superficiales a la fascia; 29,2% de estos pacientes no disponían de una prueba de imagen previa. No se ha demostrado que una cirugía «whoops» pueda suponer una disminución de la supervivencia o una mayor tasa de recidivas. Conclusiones: Recomendamos la realización de una prueba de imagen siempre previa a la extirpación de cualquier tipo de tumoración de tejidos blandos, así como la adherencia a las guías de remisión a centros de referencia.(AU)

Introduction: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions (“whoops” surgeries). This study evaluates the frequency of these type of procedures, trying to indentify patient characteristics, tumors, surgical treatment and final results. Material and methods: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with chi2 tests and a Cox multivariate regression model. Results: Unplanned excisions of SPBAL have taken place in 18% of the patients in our área, mainly in tumors of less than 5 cm and located superficial to the fascia. 29,2% of these patients did not have a previous imaging test. It has not been shown that a “whoops” surgery can lead to a decrease in survival or a higher rate of recurrences. Conclusions: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumor, as well as adherence to the referral guidelines to reference centers.(AU)

[Translated article] Unplanned excision of soft tissue sarcomas of the musculoskeletal system / Resección no planificada en sarcomas de partes blandas del aparato locomotor

Introducción: El proceso diagnóstico de los sarcomas de partes blandas del aparato locomotor (SPBAL) sigue siendo comprometido, con casos de resecciones no planificadas (cirugías «whoops»). Este estudio evalúa la frecuencia de este tipo de procedimientos, tratando de identificar características de los pacientes, tumores, tratamiento quirúrgico y resultados. Material y métodos: Se revisan de forma retrospectiva 131 pacientes tratados de forma quirúrgica en nuestro centro entre octubre de 2018 y diciembre de 2021 de un SPBAL. Se excluyen los pacientes con SPBAL localizados en vísceras, mediastino, corazón, retroperitoneo, peritoneo y aparato genital. Las diferencias entre pacientes con resecciones planificadas y no planificadas fueron evaluadas con pruebas χ2 y un modelo de regresión multivariado de Cox. Resultados: Las resecciones no planificadas de SPBAL han tenido lugar en 18% de los pacientes de nuestra área, principalmente en tumores menos de 5 cm y localizados superficiales a la fascia; 29,2% de estos pacientes no disponían de una prueba de imagen previa. No se ha demostrado que una cirugía «whoops» pueda suponer una disminución de la supervivencia o una mayor tasa de recidivas. Conclusiones: Recomendamos la realización de una prueba de imagen siempre previa a la extirpación de cualquier tipo de tumoración de tejidos blandos, así como la adherencia a las guías de remisión a centros de referencia.(AU)

Introduction: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions (“whoops” surgeries). This study evaluates the frequency of these type of procedures, trying to indentify patient characteristics, tumors, surgical treatment and final results. Material and methods: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with chi2 tests and a Cox multivariate regression model. Results: Unplanned excisions of SPBAL have taken place in 18% of the patients in our área, mainly in tumors of less than 5 cm and located superficial to the fascia. 29,2% of these patients did not have a previous imaging test. It has not been shown that a “whoops” surgery can lead to a decrease in survival or a higher rate of recurrences. Conclusions: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumor, as well as adherence to the referral guidelines to reference centers.(AU)

[Translated article] Unplanned excision of soft tissue sarcomas of the musculoskeletal system.

INTRODUCTION: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions ("whoops" surgeries). This study evaluates the frequency of these type of procedures, trying to identify patient characteristics, tumours, surgical treatment and final results. MATERIAL AND METHODS: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with Chi2 tests and a Cox multivariate regression model. RESULTS: Unplanned excisions of SPBAL have taken place in 18% of the patients in our area, mainly in tumours of less than 5cm and located superficial to the fascia. 29.2% of these patients did not have a previous imaging test. It has not been shown that a "whoops" surgery can lead to a decrease in survival or a higher rate of recurrences. CONCLUSIONS: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumour, as well as adherence to the referral guidelines to reference centres.

Unplanned excision of soft tissue sarcomas of the musculoskeletal system. / Resección no planificada en sarcomas de partes blandas del aparato locomotor.

INTRODUCTION: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions ("whoops" surgeries). This study evaluates the frequency of these type of procedures, trying to indentify patient characteristics, tumors, surgical treatment and final results. MATERIAL AND METHODS: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with chi2 tests and a Cox multivariate regression model. RESULTS: Unplanned excisions of SPBAL have taken place in 18% of the patients in our área, mainly in tumors of less than 5 cm and located superficial to the fascia. 29,2% of these patients did not have a previous imaging test. It has not been shown that a "whoops" surgery can lead to a decrease in survival or a higher rate of recurrences. CONCLUSIONS: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumor, as well as adherence to the referral guidelines to reference centers.

Estudio de viabilidad y adhesividad celular de osteoblastos a cementos óseos utilizados en técnicas de refuerzo vertebral, mezclados con hidroxiapatita a distintas concentraciones / Study of the viability and adhesion of osteoblast cells to bone cements mixed with hydroxyapatite at different concentrations to use in vertebral augmentation techniques

Objetivo: El objetivo de este estudio es comparar la biocompatibilidad y efecto sobre osteoblastos de polimetilmetacrilato solo y PMMA al que se ha añadido, hidroxiapatita en concentraciones del 5, 10, 15 y 20%, no superando nunca esta cifra del 20%, dado que si se supera esta cifra pueden verse alteradas las propiedades biomecánicas del PMMA. Material y métodos: Estudio experimental que consiste en el estudio de la adhesividad, diferenciación y muerte celular sobre discos de PMMA y composite PMMA/HA a diferentes concentraciones. Resultados: Los composites al 15 y especialmente al 20% presentaron mejor respuesta osteoblástica, mayores marcadores de actividad y menores marcadores de apoptosis. En las imágenes de microcopía electrónica se aprecia una mayor adhesión celular (AU)

Objective: The purpose of this study is to compare the biocompatibility and the effect in osteoblasts of polymethyl methacrylate alone, and mixed with hydroxyapatite in different concentrations of 5, 10, 15 and 20%, without exceeding 20%, as it can alter mechanical properties of the composite. Material and methods: Experimental study comparing osteoblast response to Polymethyl methacrylate alone and with hydroxyapatite in different concentrations. Results: Composites at 15 and 20% obtained better osteoblast response, with higher osteoblastic activity markers, and lower apoptosis markers. Electron microscopy images show improved adhesion of osteoblasts (AU)

Study of the viability and adhesion of osteoblast cells to bone cements mixed with hydroxyapatite at different concentrations to use in vertebral augmentation techniques.

OBJECTIVE: The purpose of this study is to compare the biocompatibility and the effect in osteoblasts of polymethyl methacrylate alone, and mixed with hydroxyapatite in different concentrations of 5, 10, 15 and 20%, without exceeding 20%, as it can alter mechanical properties of the composite. MATERIAL AND METHODS: Experimental study comparing osteoblast response to Polymethyl methacrylate alone and with hydroxyapatite in different concentrations. RESULTS: Composites at 15 and 20% obtained better osteoblast response, with higher osteoblastic activity markers, and lower apoptosis markers. Electron microscopy images show improved adhesion of osteoblasts.