Osaka Shunzo, Matsuzaki Hiromi, Osaka Eiji, Yoshida Yukihiro, Ryu Junnosuke
Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
Anticancer Res. 2008 Nov-Dec;28(6B):4143-7.
We conducted a retrospective study comparing 5 patients (Group A) who underwent posterior excision of tumors distal to S2 using a modified threadwire saw (MT-saw) with 5 similar patients (Group B) who underwent tumor excision using chisels and airtomes.
The data of 10 patients were obtained from intra-operative records. A flexible silver guide probe connected to an MT-saw by a suture thread was devised for use in osteotomy passing through the S1 sacral canal in the lateral sacrum. Operative time, blood loss and excisional margins were compared between the two groups.
Group A had a shorter average operative time (2 hours 24 minutes) and smaller average blood loss (2,124.6 ml) than Group B. In Group A, one patient incurred an S1 nerve root injury, and all patients had wide histological margins. In Group B, one patient had an S1 nerve root injury and another tumor contamination due to a fracture.
The MT-saw greatly facilitated lateral sacral osteotomy and reduced the risk of tumor cell spread, permitting faster, safer excision with a wider margin.
我们进行了一项回顾性研究，比较了5例使用改良线锯（MT锯）进行S2远端肿瘤后路切除的患者（A组）和5例使用凿子和气动骨钻进行肿瘤切除的类似患者（B组）。
从手术记录中获取10例患者的数据。设计了一种通过缝线连接到MT锯的柔性银质导向探针，用于在骶骨外侧穿过S1骶管进行截骨术。比较两组的手术时间、失血量和切除边缘。
A组的平均手术时间（2小时24分钟）比B组短，平均失血量（2124.6毫升）比B组少。在A组中，1例患者发生S1神经根损伤，所有患者的组织学边缘均较宽。在B组中，1例患者发生S1神经根损伤，另1例因骨折导致肿瘤污染。
MT锯极大地促进了骶骨外侧截骨术，降低了肿瘤细胞扩散的风险，能够更快、更安全地进行切除，且切除边缘更宽。
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