Manabe Jun, Ahmed Adel Refaat, Kawaguchi Noriyoshi, Matsumoto Seiichi, Kuroda Hiroshi
Department of Orthopedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Clin Orthop Relat Res. 2004 Feb(419):258-66. doi: 10.1097/00003086-200402000-00042.
For skeletal reconstruction in surgery for bone tumors, pasteurization of bone has been used with favorable results over autoclaving or boiling. Twenty-three patients with primary malignant bone tumors and two patients with soft tissue sarcoma invading bone reconstruction surgery with pasteurized autologous bone graft comprised the study group. There were 16 females and nine males, between 7 and 77 years of age who were followed up for at least 3 years (mean, 52 months). The International Society of Limb Salvage graft evaluation method was used for evaluation of the radiographs. Fifteen patients (60%) had complete incorporation of the graft and eight patients (32%) had partial incorporation. Viability of the grafts was evaluated by bone scintigraphy. Of 22 patients evaluated, uptake was detected in 17 patients from approximately 6 months postoperatively after which it increased gradually. The functional results were assessed by the system of the Musculoskeletal Tumor Society, and the mean functional rating was 86%. Eighteen patients have been disease-free and seven have died of disease. Fracture (12%) and infection (20%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone may be a useful option for reconstruction after resection of malignant bone tumors. The advantages of extracorporeal pasteurization include convenience of use, avoidance of intraspecies infection and allogenic reactions, and satisfactory bone remodeling.
在骨肿瘤手术的骨骼重建中，与高压灭菌或煮沸相比，已采用骨巴氏消毒法并取得了良好效果。本研究组包括23例原发性恶性骨肿瘤患者和2例软组织肉瘤侵犯骨骼并接受巴氏消毒自体骨移植重建手术的患者。其中女性16例，男性9例，年龄在7至77岁之间，随访至少3年（平均52个月）。采用国际肢体保全协会的移植物评估方法对X线片进行评估。15例患者（60%）移植骨完全融合，8例患者（32%）部分融合。通过骨闪烁显像评估移植物的活力。在接受评估的22例患者中，17例患者在术后约6个月检测到摄取，此后逐渐增加。功能结果采用肌肉骨骼肿瘤学会系统进行评估，平均功能评分86%。18例患者无病生存，7例患者死于疾病。骨折（12%）和感染（20%）是主要并发症。未检测到局部复发。这些结果表明，骨巴氏消毒法可能是恶性骨肿瘤切除术后重建的一种有用选择。体外巴氏消毒法的优点包括使用方便、避免种内感染和同种异体反应以及令人满意的骨重塑。
