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[使用大块骨移植进行恶性骨肿瘤保肢手术]

[Limb-saving surgery of malignant bone tumors using massive bone grafts].

作者信息

Takeuchi S, Kasai C, Hori H, Satoh M, Kushida Y, Nishimoto Y, Yang C J, Hashimoto Y

机构信息

Dept. of Orthopaedic Surgery, Gifu University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 1989 Apr;16(4 Pt 2-3):1811-9.

PMID:2543323
Abstract

The artificial materials in limb-saving surgery pose problems such as the age of patient, tolerance and stability. Thus, massive bone grafting should be reconsidered. In our clinic, out of 78 patients having malignant bone tumors, 29 received limb-saving surgery, and 10 of these cases received massive bone grafting using autografts and/or frozen allografts between 1968 and 1987. There were 7 cases with osteosarcoma, 1 case with mesenchymal chondrosarcoma, 1 case with leiomyosarcoma and 1 case with malignant fibrous histiocytoma. There were 5 males and 5 females ranging in age from 11 years to 44 years, and averaging 21 years. According to Enneking's staging system, these were all II-B cases. The median follow-up period was 71 mos, ranging from 13 to 239 mos. According to the modified Amago evaluation method, 80% of these cases had an excellent prognosis, one had a recurrence, but in all cases good bone union and stability were achieved without immunological reaction. Therefore we conclude that massive bone grafts in cases of malignant bone tumor surgery is a very beneficial method.

摘要

保肢手术中的人工材料存在诸如患者年龄、耐受性和稳定性等问题。因此,应重新考虑大块骨移植。在我们诊所,78例患有恶性骨肿瘤的患者中,29例接受了保肢手术,其中10例在1968年至1987年间使用自体骨和/或冷冻异体骨进行了大块骨移植。其中骨肉瘤7例,间叶性软骨肉瘤1例,平滑肌肉瘤1例,恶性纤维组织细胞瘤1例。患者共10例,男5例,女5例,年龄11岁至44岁,平均21岁。根据恩neking分期系统,这些均为II - B期病例。中位随访期为71个月,范围为13至239个月。根据改良的天尾评估方法,这些病例中有80%预后良好,1例复发,但所有病例均实现了良好的骨愈合和稳定性,且无免疫反应。因此我们得出结论,恶性骨肿瘤手术中进行大块骨移植是一种非常有益的方法。

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