Simon M A
Department of Surgery, Section Orthopaedic Surgery and Rehabilitation Medicine, Chicago, Illinois 60637.
Clin Orthop Relat Res. 1991 Sep(270):264-70.
The incidence of local recurrences following limb salvage performed by experienced surgeons with wide surgical margins and with the use of neoadjuvant chemotherapy is sufficiently low (5%-10%) so as not to have a biologically statistically significant impact on the long-term survival rate. Following limb salvage, the incidence of morbidity increases with a few patients occasionally requiring prolonged or repeated hospitalizations and further surgical procedures, even amputation. The durability of the reconstructions is variable, and many of the mobile knee reconstructions may need to be revised if the patients become long-term survivors. The function of salvaged limbs is better than that after the alternative amputation, but none of the reconstructions will give normal function. Finally, no matter which type of surgery on the lower extremity is selected, patients will have a good early psychosocial adjustment if no premorbid psychosocial disorder is present.
由经验丰富的外科医生进行广泛手术切缘并使用新辅助化疗后进行保肢治疗,局部复发的发生率足够低(5%-10%),以至于对长期生存率没有生物学统计学上的显著影响。保肢治疗后,发病率会增加,少数患者偶尔需要延长住院时间或反复住院以及进一步的手术,甚至截肢。重建的耐用性各不相同,如果患者成为长期幸存者,许多可活动膝关节重建可能需要翻修。保肢肢体的功能优于截肢后的功能,但没有一种重建能恢复正常功能。最后,无论选择哪种类型的下肢手术,如果术前没有心理社会障碍,患者都会有良好的早期心理社会适应。