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采用扩大病灶内刮除术并使用苯酚作为局部辅助剂治疗软骨母细胞瘤。

Surgical treatment of chondroblastoma using extended intralesional curettage with phenol as a local adjuvant.

作者信息

Zekry Karem M, Yamamoto Norio, Hayashi Katsuhiro, Takeuchi Akihiko, Araki Yoshihiro, Alkhooly Ali Zein Aa, Abd-Elfattah Ahmed Saleh, Fouly Ezzat H, Elsaid Ahmed Nady Saleh, Tsuchiya Hiroyuki

机构信息

1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.

2 Department of Orthopaedic Surgery, Faculty of Medicine, Minia University, Minya, Egypt.

出版信息

J Orthop Surg (Hong Kong). 2019 Sep-Dec;27(3):2309499019861031. doi: 10.1177/2309499019861031.

Abstract

PURPOSE

The aim of this study is to report the clinical and radiological outcomes following surgical treatment of chondroblastoma by means of an extended intralesional curettage using high-speed burr, with phenol as a local adjuvant which is followed by the implantation of synthetic bone graft, aiming to lower the recurrence rate of this tumor.

PATIENTS AND METHODS

This retrospective study included 20 patients with chondroblastoma lesions during the period between 2000 and 2015.

RESULTS

Fifteen males and five females were followed up for a mean of 63.35 (26-144) months with average age at the time of presentation was 20.8 (range: 12-32) years. Nineteen patients (95%) were complaining of pain at the time of presentation, and the lesion was discovered accidently in one patient. The mean operative time was 138.5 min (75-250). At the most recent follow-up, all patients had regained full physical function without pain at the operation site.

CONCLUSION

The aggressive treatment of chondroblastoma by an extended intralesional curettage using high-speed burr with phenol as a local adjuvant seems effective in lowering the incidence of local recurrence and secondary more aggressive surgeries. Implantation of the bone defects that result from curettage with the synthetic bone substitutes is a good alternative due to rapid restoration of the mechanical strength with good remodeling.

摘要

目的

本研究旨在报告采用高速磨钻进行扩大病灶内刮除术,并以苯酚作为局部辅助剂,随后植入人工骨移植材料治疗软骨母细胞瘤的临床和放射学结果,旨在降低该肿瘤的复发率。

患者与方法

这项回顾性研究纳入了2000年至2015年期间的20例软骨母细胞瘤患者。

结果

15例男性和5例女性患者接受了平均63.35(26 - 144)个月的随访,就诊时的平均年龄为20.8岁(范围:12 - 32岁)。19例患者(95%)就诊时主诉疼痛,1例患者的病灶为偶然发现。平均手术时间为138.5分钟(75 - 250分钟)。在最近一次随访时,所有患者均恢复了完全的身体功能,手术部位无疼痛。

结论

采用高速磨钻进行扩大病灶内刮除术并以苯酚作为局部辅助剂积极治疗软骨母细胞瘤,似乎在降低局部复发率和二次更激进手术发生率方面有效。用人工骨替代物填充刮除造成的骨缺损是一种很好的选择,因为它能快速恢复机械强度并具有良好的重塑效果。

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