Surgical Procedures for Myelodysplastic Syndrome (MDS)
En Español (Spanish Version)

Two surgical procedures for MDS include:
  • Bone marrow biopsy (both to diagnose and monitor the disease)
  • Central venous infusaport placement

Bone Marrow Biopsy
One minor surgical procedure you will need is a biopsy of your bone marrow. In a bone marrow biopsy, a sample of bone marrow and a small piece of bone are removed and tested for cancer cells. (This procedure is done under a local anesthesia. You may also receive a medication prior to the procedure that will help you relax.) The samples are obtained by inserting a larger than usual needle through either the top of your pelvis or your breastbone into the soft, spongy marrow. Once there, firm suction on a syringe draws out approximately 2 teaspoons of marrow fluid. Then, a second puncture with the core biopsy needle removes a small piece of tissue. The procedure takes 10-15 minutes and is done in the doctor’s office. You will go home with a band-aid or dressing on the site that should remain in place for 24 hours.

Some of the biopsy sample will be evaluated by the hematologist and pathologist under the microscope. Some will be sent to the lab to evaluate the chromosomes and DNA for damage. This evaluation, called a cytogenetic study, will help your doctor determine the prognosis of your type of MDS.

A bone marrow biopsy is necessary to identify your disease precisely. Subsequent marrow biopsies may be helpful to assess your progress, but the first one is essential.

Effectiveness
Bone marrow biopsies are inconclusive when the marrow contains too few cellular elements. This is not usually the case with MDS.

Possible Complications
Because your disease makes you prone to bleeding and infection, you may be at slightly higher risk for these than normal. However, the procedure is not much riskier than drawing blood from a vein.

Postoperative Care
Watch for bleeding and signs of infection.

Central Venous Infusaport Placement
When the need for venous access for medication is great, your doctor may sometimes recommend the insertion of a central venous access device under the skin, usually beneath the collarbone. This device, referred to as a “port” can be used to draw blood and to administer blood products or antibiotics. It is often useful if your veins are small or few in number. Because patients with MDS require frequent transfusions in many cases, this device can improve the quality of life for patients by decreasing the need for needle punctures in the arms. Your doctor can discuss the risks and benefits of having such a port with you.




References:
Castro-Malaspina H, O’Reilly RJ. Aplastic anemia and the myelodysplastic syndromes. In: Kasper DL, Harrison TR. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

Silverman LR. Myelodysplastic syndrome. American Cancer Society website. Available at: http://www.nci.nih.gov/cancer_information/ . Accessed November 30, 2002.

Last Reviewed December 2013



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