Haidar Rachid, Sagghieh Said, Muwakitt Samar, Mumtaz Ghina, Akel Samir, Kamzoul Rami, Farah Roula, Noun Peter, Khalifeh Hassan, Farhat Fadi, Razzouk Bassem, Rodriguez Galindo Carlos, Rao Bhaskar, Abboud Miguel R
Children's Cancer Center of Lebanon, American University of Beirut-Medical Center, Beirut, Lebanon.
Pediatr Blood Cancer. 2008 Dec;51(6):787-91. doi: 10.1002/pbc.21696.
To describe the 5-year experience of a multidisciplinary limb salvage program for children and adolescents with malignant bone tumors in Lebanon.
Between January 2002 to February 2007, 30 children and adolescents (2 with Ewing sarcoma and 28 with osteosarcoma) underwent Limb Salvage Surgeries (LSS) at the American University of Beirut Medical Center after partnering with the multidisciplinary team at St. Judes Children's Research Hospital (SJCRH). Procedures performed included 12 Repiphysis, noninvasively expandable, prostheses inserted in skeletally immature children, 15 modular prostheses, 2 allografts and 1 rotationplasty. All patients received pre- and postoperative chemotherapy.
With a mean follow-up of 31 months, 20 patients are now off therapy, 4 died, and 6 are receiving chemotherapy (3 due to pulmonary recurrence). Complications of surgery included infections in three cases, failure of the expansion mechanism in two, femoral stem fracture in one, prostheses femoral stem loosening in one and wound dehiscence in one. Lengthening of Repiphysis prostheses was achieved by subjecting the limb to an electromagnetic field that would allow controlled release of the Repiphysis expansion mechanism. Ten patients underwent a total of 42 lengthening procedures with an average of 9 mm lengthened per procedure (range 2-15 mm). All patients have good function of the affected limb.
Our LSS results are comparable to those reported in the literature. Collaboration with SJCRH and fund raising were critical to the program's success. This endeavor could serve as a model for establishing LSS programs in developing countries.
描述黎巴嫩针对患有恶性骨肿瘤的儿童和青少年开展多学科保肢计划的5年经验。
2002年1月至2007年2月期间，30名儿童和青少年（2例尤因肉瘤，28例骨肉瘤）在美国贝鲁特美国大学医学中心与圣裘德儿童研究医院（SJCRH）的多学科团队合作后接受了保肢手术（LSS）。实施的手术包括12例为骨骼未成熟儿童插入的骺板、无创可扩张假体，15例模块化假体，2例同种异体移植和1例旋转成形术。所有患者均接受了术前和术后化疗。
平均随访31个月，20例患者现已停止治疗，4例死亡，6例正在接受化疗（3例因肺部复发）。手术并发症包括3例感染，2例扩张机制故障，1例股骨干骨折，1例假体股骨干松动和1例伤口裂开。通过对肢体施加电磁场来实现骺板假体的延长，这将允许骺板扩张机制的可控释放。10例患者共进行了42次延长手术，每次手术平均延长9毫米（范围2 - 15毫米）。所有患者患侧肢体功能良好。
我们的保肢手术结果与文献报道的结果相当。与圣裘德儿童研究医院的合作和筹款对该计划的成功至关重要。这一努力可为在发展中国家建立保肢计划提供一个模式。
