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脑肿瘤手术中的颅骨修补术:一项单中心回顾性研究,探讨颅骨修补术失败和肿瘤复发的情况。

Cranioplasty in Brain Tumor Surgery: A Single-Center Retrospective Study Investigating Cranioplasty Failure and Tumor Recurrence.

机构信息

Section of Neurosurgery, Department of Neuroscience, Uppsala University Hospital, Uppsala, Sweden.

Section of Neurosurgery, Department of Neuroscience, Uppsala University Hospital, Uppsala, Sweden.

出版信息

World Neurosurg. 2023 Feb;170:e313-e323. doi: 10.1016/j.wneu.2022.11.010. Epub 2022 Nov 7.

DOI:10.1016/j.wneu.2022.11.010
PMID:36356841
Abstract

OBJECTIVE

Cranioplasty with synthetic implant can be performed to restore function and form of the skull after resection of malignancy infiltrating the bone. The aim of this study was to examine the rate of implant failure and tumor recurrence in patients undergoing nonautologous cranioplasty and tumor resection.

METHODS

In this retrospective single-center study, 48 patients were identified who had undergone cranioplasty with synthetic implants after tumor resection between 2010 and 2020. The medical records were analyzed to investigate patient demographics, surgery data, cranioplasty failure rates, and rate of tumor recurrence.

RESULTS

Cranioplasty failed in 8 patients. The median time to implant failure was 220 days with most failures occurring within 1 year (5 of 8). There was no significant difference in rate or time to failure between the different cranioplasty materials (P = 0.39). Low body mass index (P < 0.05), previous craniectomy/cranioplasty (P < 0.05), previous radiation therapy to the brain/skull (P < 0.05), and skin closure with sutures (P < 0.05) were associated with an increased risk of implant failure. Tumors recurred in 15 patients.

CONCLUSIONS

Cranioplasty surgery with synthetic implants carries a relatively high risk of failure, regardless of type of cranioplasty material used. Skin closure with staples may be beneficial in these patients.

摘要

目的

颅骨切除术切除浸润颅骨的恶性肿瘤后,可使用合成植入物进行颅骨成形术,以恢复颅骨的功能和形态。本研究旨在检查行非自体颅骨成形术和肿瘤切除术患者的植入物失败和肿瘤复发率。

方法

在这项回顾性单中心研究中,共确定了 48 例在 2010 年至 2020 年间因肿瘤切除而行颅骨成形术的患者。分析病历以调查患者人口统计学数据、手术数据、颅骨成形术失败率和肿瘤复发率。

结果

8 例患者颅骨成形术失败。植入物失败的中位时间为 220 天,大多数失败发生在 1 年内(8 例中有 5 例)。不同颅骨成形材料的失败率和时间无显著差异(P=0.39)。低体重指数(P<0.05)、既往开颅术/颅骨成形术(P<0.05)、既往脑部/颅骨放疗(P<0.05)和皮肤缝合采用缝线(P<0.05)与植入物失败风险增加相关。15 例患者肿瘤复发。

结论

无论使用哪种颅骨成形材料,使用合成植入物的颅骨成形术都有相对较高的失败风险。在这些患者中,使用吻合器进行皮肤缝合可能有益。

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