Reilly K E, Stern P J, Dale J A
Department of Orthopaedic Surgery, University of Cincinnati College of Medicine and Hand Surgery Specialists, OH 45206, USA.
J Hand Surg Am. 1999 Nov;24(6):1298-302. doi: 10.1053/jhsu.1999.1298.
Seventy patients underwent surgical excision of a giant cell tumor of the tendon sheath. The patients were monitored for an average of 3 years 4 months. Nineteen of the 70 patients (27%) had a surgically and histologically documented recurrence at an average of 2 years 3 months (range, 3 months to 10 years) following the initial procedure. Eight of 19 patients (42%) with recurrence had a prior recurrence. Statistically significant risk factors for recurrence included presence of adjacent degenerative joint disease, location at the distal interphalangeal joint of the finger or interphalangeal joint of the thumb, and radiographic presence of an osseous pressure erosion. Age, gender, size, and location within the digit (volar vs. dorsal) were not risk factors for recurrence. Awareness of these associations should be reflected in the surgeon's approach and preoperative discussion with the patient.
70例患者接受了腱鞘巨细胞瘤的手术切除。对这些患者平均随访3年4个月。70例患者中有19例(27%)在初次手术后平均2年3个月(范围为3个月至10年)出现手术及组织学证实的复发。19例复发患者中有8例(42%)曾有过复发。复发的统计学显著危险因素包括存在相邻的退行性关节病、位于手指远侧指间关节或拇指指间关节、以及影像学上存在骨压迫性侵蚀。年龄、性别、肿瘤大小和手指内的位置(掌侧与背侧)不是复发的危险因素。外科医生的手术方式及与患者的术前讨论应体现对这些关联的认识。