Waldron B, Moran R M, Hurson B J
Cappagh Orthopaediac Hospital, Finglas, Dublin.
Ir J Med Sci. 1990 Aug;159(8):246-8. doi: 10.1007/BF02937380.
The problems of biopsy procedures and the effect that these had on subsequent surgery were studied in fifty one consecutive patients with musculoskeletal tumours. Difficulties included inadequate tissue for histology in 4 patients, wound infection in 5, haematoma formation in 2, inappropriate biopsy site in 7 and incorrect placement of drain exit site in 4. Open biopsy gave a more reliable diagnosis than needle biopsy, but was associated with a higher incidence of complications. Staging techniques such as magnetic resonance imaging, computed tomography and bone scans were less accurate when performed after the biopsy. Longitudinal incisions, centred over representative tumour tissue with the drain site placed in line with the incision, facilitate the adequate and uncomplicated removal of the entire biopsy scar and tract at the time of the definitive surgical procedure. It is concluded that biopsy for suspected musculoskeletal tumours should not be delegated to junior residents and should be performed in centres that have experience in the management of such tumours.
对51例连续的肌肉骨骼肿瘤患者进行了活检程序问题及其对后续手术影响的研究。困难包括4例患者组织学检查的组织不足、5例伤口感染、2例血肿形成、7例活检部位不当以及4例引流出口部位放置错误。切开活检比针吸活检能提供更可靠的诊断，但并发症发生率更高。活检后进行的磁共振成像、计算机断层扫描和骨扫描等分期技术准确性较低。纵向切口以代表性肿瘤组织为中心，引流部位与切口对齐，便于在确定性手术时充分且无并发症地切除整个活检瘢痕和通道。结论是，疑似肌肉骨骼肿瘤的活检不应委托给低年资住院医师，而应在有此类肿瘤管理经验的中心进行。
