Guder W K, Hardes J, Gosheger G, Nottrott M, Streitbürger A
Klinik für Allgemeine und Tumororthopädie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland.
Chirurg. 2015 Oct;86(10):993-1003; quiz 1004. doi: 10.1007/s00104-015-0082-0.
A wide tumor resection is essential in the therapy of primary malignant bone tumors to minimize the risk of local recurrence and ensure long-term survival. While chondrosarcoma is mainly treated surgically, osteosarcoma therapy consists of both chemotherapy and surgical resection of the tumor. While endoprosthetic replacement after hemipelvectomy tends to be associated with high infection rates and has been superseded by hip transposition and composite osteosynthetic replacements, the use of megaendoprosthetic tumor prostheses is the most common reconstruction technique when the extremities are affected. Biological reconstruction or ablative procedures are reserved for special indications. Overall, the reconstruction techniques presented in this article manage to ensure limb salvage in most patients. Functional outcome, however, greatly depends on the tumor size and site as well as postoperative residual soft tissue coverage.
广泛的肿瘤切除对于原发性恶性骨肿瘤的治疗至关重要,可将局部复发风险降至最低并确保长期生存。虽然软骨肉瘤主要通过手术治疗,但骨肉瘤的治疗包括化疗和肿瘤的手术切除。半骨盆切除术后的人工关节置换往往伴随着高感染率,现已被髋关节转位和复合骨合成置换所取代,当四肢受到影响时,使用大型人工肿瘤假体是最常见的重建技术。生物重建或切除手术则适用于特殊适应症。总体而言,本文介绍的重建技术在大多数患者中成功确保了肢体保全。然而,功能结果在很大程度上取决于肿瘤大小、部位以及术后残余软组织覆盖情况。