Steinau H-U, Hauser J, Farzaliyev F, Podleska L
Klinik für Unfallchirurgie/Plastische Chirurgie, Sarkomzentrum am Westdeutschen Tumorzentrum CCC, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufeland Str. 55, 45147, Essen, Deutschland,
Chirurg. 2014 Mar;85(3):215-20, 222-3. doi: 10.1007/s00104-013-2603-z.
Multimodal treatment of malignant tumors of the musculoskeletal system with R0 in sano resection plays a key role in prevention of local recurrence in soft tissue and bone sarcoma. In cases of unavoidable neuromuscular or osseous defects, current plastic and orthoplastic reconstruction techniques avoid limb amputation in the majority of patients. Clinical long-term results demonstrate that large resection defects do not necessarily result in impaired limb function if multidisciplinary procedures are integrated. In oncologically necessary major limb amputation, segmental resection and replantation of distal limb parts should be considered which provide end-bearing long stump formation. The functional conditions of long-term surviving elderly patients should be integrated into surgical decision-making and rehabilitation efforts.
在肌肉骨骼系统恶性肿瘤的多模式治疗中，进行R0根治性切除对预防软组织和骨肉瘤的局部复发起着关键作用。在不可避免地出现神经肌肉或骨缺损的情况下，目前的整形和正颌整形重建技术可使大多数患者避免截肢。临床长期结果表明，如果采用多学科手术，大面积切除缺损不一定会导致肢体功能受损。在肿瘤学上必要的大肢体截肢手术中，应考虑进行节段性切除和远端肢体部分的再植，以形成有承重能力的长残端。长期存活老年患者的功能状况应纳入手术决策和康复工作中。
