Preoperative embolization reduces blood loss and recurrence in aneurysmal bone cyst surgery: A retrospective cohort study.

AIM: This study aims to evaluate the effectiveness of preoperative embolization in reducing intraoperative blood loss and transfusion requirements, as well as its impact on recurrence in patients with histopathologically confirmed aneurysmal bone cysts (ABCs).

METHODS

A retrospective review was conducted on 107 patients who underwent surgical treatment for ABC at a tertiary oncology center between 2004 and 2023. Patients were grouped based on whether they received preoperative embolization (n = 50) or not (n = 57). Data collected included demographic features, lesion location, estimated blood loss (EBL), erythrocyte suspension (ES) transfusion volume, operative time, VAS scores, and recurrence rates.

RESULTS

Patients in the embolization group had significantly lower EBL (772 ± 445.4 ml vs. 1220.17 ± 523.37 ml; p < 0.001), VAS scores (2.14 ± 1.92 vs. 3.61 ± 2.52; p = 0.002), and ES transfusion volumes (312 ± 337.2 ml vs. 580.7 ± 394.8 ml; p < 0.001). Recurrence rates were also lower in the embolization group (8 % vs. 24.6 %; p = 0.023). Operative time did not differ significantly (p = 0.089).

CONCLUSION

In conclusion, the use of preoperative embolization in patients with aneurysmal bone cysts may help reduce intraoperative blood loss, transfusion requirements, and the likelihood of postoperative recurrence. In light of its potential to minimize both intraoperative complications and long-term recurrence, embolization should be considered as a component of preoperative planning in appropriately selected cases of ABC.