DOI: https://doi.org/10.25305/unj.204079

Comparison of the effectiveness of endoscopic and open transthoracic removal of tumors of the thoracic vertebrae

Ievgenii I. Slynko, Yuriy V. Derkach

Abstract


The aim of the study was to compare and evaluate the effectiveness of endoscopic and open transthoracic removal of tumors of the thoracic vertebrae.

Materials and methods. A one-center retrospective cohort study was conducted. We compared the data of two groups each consisted of 30 patients with tumors of the thoracic spine. In the first group, open transthoracic removals of tumors of the thoracic vertebrae were performed, in the second group exclusively endoscopic.

The criteria for inclusion of patients were as follows: 1. Patients of any sex and age who underwent inpatient treatment at the State Institution “Romodanov Neurosurgery Institute of NAMSU” in the period from 2010 to 2020; 2. The diagnosis was verified histologically and/or by neuroimaging technology; 3. The primary localization of the tumor is in the thoracic spine.

Results. The endoscopic interventions were associated with statistically significantly (P < 0.05) 1) longer all time of operation; 2) less blood loss; 3) longer implant placement time; 4) less frequency of dural sac visualization.

Immediately after surgery, the mean score on the McCormick scale in the group of direct surgery was 3.2, in the group of endoscopic 3.3. The difference was not statistically significant. Pain syndrome on a Visual Analogue Scale was 4.2 points in the first group, in the second — 2.5. The difference was not statistically significant.

In the group of endoscopic interventions, the frequency of local recurrences is significantly higher, out of 22 patients available for evaluation, 11 (50 %) individuals have a local recurrence of the tumor. Compared with open interventions out of 21 available for assessment, recurrences were found only in 3 patients, which is 14.2 %. The difference in the frequency of redistribution is statistically significant (P < 0.05). We attribute this to the fact that endoscopic interventions reduce the radical removal of tumors.

Conclusions. At endoscopic interventions, it is statistically significantly 1) longer all time of operation; 2) less blood loss; 3) longer implant placement time; 4) less frequency of the dural sac visualization.


Keywords


tumors of vertebral bodies; endoscopic removal of tumors; thoracic spine

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