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肩胛骨肿瘤行肩胛骨切除术后的功能及肿瘤学结果:2至16年的随访结果

The functional and oncological results after scapulectomy for scapular tumours: 2-16-year results.

作者信息

Mayil Vahanan N, Mohanlal P, Bose J C, Gangadharan R, Karthisundar V

机构信息

Department of Orthopaedics & Trauma, Madras Medical College & Research Institute, Govt. General Hospital, Chennai, India.

出版信息

Int Orthop. 2007 Dec;31(6):831-6. doi: 10.1007/s00264-006-0261-1. Epub 2006 Oct 17.

Abstract

Twenty-five patients underwent scapulectomy for various tumours between 1989 and 2005. We describe 23 patients with scapular tumours who were followed-up for a minimum of 2 years after scapulectomy. The average age was 29 years, and two-thirds of the patients were male. Nineteen patients had malignant neoplasms, of which chondrosarcoma was most common, followed by Ewing's sarcoma. Surgical staging was by Enneking's system, with stage IIB being the most frequent. Fifteen patients underwent total scapulectomy, and the rest had their glenoid retained. With an average follow-up period of 66.7 months (23-202 months), functional and oncological outcomes were evaluated for all patients. Two patients had superficial wound infections requiring antibiotics, and one had skin necrosis requiring skin cover. Functional outcome was satisfactory in 13 patients. Cosmetically and emotionally acceptable surgery, scapulectomy made 19 patients continuously disease free, while four patients died of disease. The 5-year survival rate of 19 patients with malignant tumours was 75.9%. Retention of the glenohumeral articulation (subtotal) resection gives superior functional results.

摘要

1989年至2005年间,25例患者因各种肿瘤接受了肩胛骨切除术。我们描述了23例肩胛骨肿瘤患者,他们在肩胛骨切除术后至少随访了2年。平均年龄为29岁,三分之二的患者为男性。19例患者患有恶性肿瘤,其中软骨肉瘤最为常见,其次是尤因肉瘤。手术分期采用Enneking系统,IIB期最为常见。15例患者接受了全肩胛骨切除术,其余患者保留了肩胛盂。平均随访期为66.7个月(23 - 202个月),对所有患者的功能和肿瘤学结果进行了评估。2例患者发生浅表伤口感染需要使用抗生素,1例患者发生皮肤坏死需要皮肤覆盖。13例患者的功能结果令人满意。肩胛骨切除术在美容和情感上可接受,使19例患者持续无病,而4例患者死于疾病。19例恶性肿瘤患者的5年生存率为75.9%。保留肩肱关节(次全)切除术可获得更好的功能结果。

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