Eidmann Annette, Lüdemann Martin, Raab Peter, Rudert Maximilian
Lehrstuhl für Orthopädie, Orthopädische Klinik König-Ludwig-Haus Würzburg, Universität Würzburg, Brettreich-Str. 11, 97074, Würzburg, Deutschland.
Chirurgie (Heidelb). 2024 Apr;95(4):288-293. doi: 10.1007/s00104-024-02049-2. Epub 2024 Feb 15.
Sarcomas of the extremities are rare entities, the treatment of which requires special expertise. Even if the treatment of patients is always interdisciplinary, the surgical R0 resection is the key point of each curatively intended treatment. In addition to resection in sano, the aim is to preserve the extremities and function, so that defect reconstruction after resection plays a decisive role. Due to the heterogeneity of tumors as well as their localization and extent, reconstruction is always an individually adapted treatment. Modular tumor endoprostheses are often used in this context, which can be constructed according to the size of the defect. The transplantation of autologous or allogeneic bone is also frequently used alone or as an additive procedure. Patient-specific (mega)prostheses are used particularly for pelvic tumors. Defect reconstruction using scaffold-based procedures from the field of tissue engineering is being tested as a promising procedure for the future. This article provides an overview of the treatment principles for sarcomas of the extremities and their individual reconstruction options.
肢体肉瘤是罕见的疾病，其治疗需要特殊的专业知识。即使对患者的治疗始终是多学科的，但手术R0切除是每种根治性治疗的关键。除了在健康状态下进行切除外，目标是保留肢体及其功能，因此切除后的缺损重建起着决定性作用。由于肿瘤的异质性及其位置和范围，重建始终是个体化的适应性治疗。在这种情况下，模块化肿瘤内置假体经常被使用，其可以根据缺损的大小进行构建。自体或异体骨移植也经常单独使用或作为附加手术。针对患者定制的（巨型）假体特别用于盆腔肿瘤。利用组织工程领域基于支架的方法进行缺损重建作为一种有前景的未来方法正在进行测试。本文概述了肢体肉瘤的治疗原则及其个体化重建选择。
