Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country

Aim: Hemophilic pseudotumors result from repeated episodes of bleeding into bone, subperiosteum, and soft tissue. Since clotting factors became available, uncontrolled perioperative bleeding is a less significant problem for surgeons in developed countries. However, they are more difficult to come b...

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Main Authors: Yu He, Xi Zhou, Haomin Cui, Guixing Qiu, Xisheng Weng, Baozhong Zhang, Yong Liu
Format: Article
Language:English
Published: Taylor & Francis Group 2019-02-01
Series:Journal of Investigative Surgery
Subjects:
Online Access:http://dx.doi.org/10.1080/08941939.2017.1386737
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author Yu He
Xi Zhou
Haomin Cui
Guixing Qiu
Xisheng Weng
Baozhong Zhang
Yong Liu
author_facet Yu He
Xi Zhou
Haomin Cui
Guixing Qiu
Xisheng Weng
Baozhong Zhang
Yong Liu
author_sort Yu He
collection DOAJ
description Aim: Hemophilic pseudotumors result from repeated episodes of bleeding into bone, subperiosteum, and soft tissue. Since clotting factors became available, uncontrolled perioperative bleeding is a less significant problem for surgeons in developed countries. However, they are more difficult to come by in China. Additionally, patients often have to undergo surgery for giant masses and suffer complications. We wanted to present our experience in the surgical management of hemophilic pseudotumors over a 40-year period. Methods: We retrospectively reviewed 429 hemorrhagic coagulopathy patients between 1983 and 2015. Diagnosis of hemophilic pseudotumor was confirmed following clinical, radiological, and pathological criteria. The data were recorded and analyzed: type and severity of hemophilia, presence of inhibitor, etiological antecedent, localization of pseudotumors, clinical signs, surgical management and outcomes. Results: Eighteen pseudotumor patients underwent surgical treatment. All of them were male, with mean age of 34.3 years. Fifteen patients had hemophilia A and three patients had hemophilia B. There were twelve proximal and two distal pseudotumor patients. The mean follow-up was 51.9 months. For pseudotumors in the extremities, complete surgical resection was achieved. For four patients with pelvic or abdominal pseudotumors, complete surgical resection was only achieved in two patients because of preventing potential vital organs injuries. Delayed healing of the incision, allergic reactions, and ureteral injury were the major complications. Conclusion: Surgery is an alternative method with safety and efficacy. Careful and individual treatment is required by the hematologist, orthopedic surgeon and other members of the team who collaborate and participate in hemophilic surgery.
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spelling doaj.art-89d5cd4b7ba043ec8afac925fb4735f82023-09-15T10:12:28ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532019-02-0132212713610.1080/08941939.2017.13867371386737Surgical Management of Haemophilic Pseudotumors: Experience in a Developing CountryYu He0Xi Zhou1Haomin Cui2Guixing Qiu3Xisheng Weng4Baozhong Zhang5Yong Liu6Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegePeking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeShanghai Jiaotong University Affiliated Sixth People's HospitalPeking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegePeking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegePeking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegePeking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeAim: Hemophilic pseudotumors result from repeated episodes of bleeding into bone, subperiosteum, and soft tissue. Since clotting factors became available, uncontrolled perioperative bleeding is a less significant problem for surgeons in developed countries. However, they are more difficult to come by in China. Additionally, patients often have to undergo surgery for giant masses and suffer complications. We wanted to present our experience in the surgical management of hemophilic pseudotumors over a 40-year period. Methods: We retrospectively reviewed 429 hemorrhagic coagulopathy patients between 1983 and 2015. Diagnosis of hemophilic pseudotumor was confirmed following clinical, radiological, and pathological criteria. The data were recorded and analyzed: type and severity of hemophilia, presence of inhibitor, etiological antecedent, localization of pseudotumors, clinical signs, surgical management and outcomes. Results: Eighteen pseudotumor patients underwent surgical treatment. All of them were male, with mean age of 34.3 years. Fifteen patients had hemophilia A and three patients had hemophilia B. There were twelve proximal and two distal pseudotumor patients. The mean follow-up was 51.9 months. For pseudotumors in the extremities, complete surgical resection was achieved. For four patients with pelvic or abdominal pseudotumors, complete surgical resection was only achieved in two patients because of preventing potential vital organs injuries. Delayed healing of the incision, allergic reactions, and ureteral injury were the major complications. Conclusion: Surgery is an alternative method with safety and efficacy. Careful and individual treatment is required by the hematologist, orthopedic surgeon and other members of the team who collaborate and participate in hemophilic surgery.http://dx.doi.org/10.1080/08941939.2017.1386737hemophiliapseudotumorsurgerymanagementpharmacological regimendeveloping country
spellingShingle Yu He
Xi Zhou
Haomin Cui
Guixing Qiu
Xisheng Weng
Baozhong Zhang
Yong Liu
Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country
Journal of Investigative Surgery
hemophilia
pseudotumor
surgery
management
pharmacological regimen
developing country
title Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country
title_full Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country
title_fullStr Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country
title_full_unstemmed Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country
title_short Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country
title_sort surgical management of haemophilic pseudotumors experience in a developing country
topic hemophilia
pseudotumor
surgery
management
pharmacological regimen
developing country
url http://dx.doi.org/10.1080/08941939.2017.1386737
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AT guixingqiu surgicalmanagementofhaemophilicpseudotumorsexperienceinadevelopingcountry
AT xishengweng surgicalmanagementofhaemophilicpseudotumorsexperienceinadevelopingcountry
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