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肘部原发性和转移性恶性肿瘤的功能和临床结果。

The functional and clinical outcomes of primary and metastatic malignancies of the elbow.

机构信息

Abdurrahman Yurtaslan Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Kliniği, 06200 Yenimahalle, Ankara, Ankara.

出版信息

Jt Dis Relat Surg. 2024 May 20;35(3):628-636. doi: 10.52312/jdrs.2024.1738.

Abstract

OBJECTIVES

This study aims to investigate the etiological distribution of primary and metastatic malignancies around the elbow and the effect of surgical and adjuvant treatments on clinical outcome.

PATIENTS AND METHODS

Between January 2006 and December 2020, medical records of a total of 33 patients with elbow neoplasm (15 males, 18 females; median age: 55 years; range, 39 to 71 years) who underwent surgical treatment and with or without clinical treatment were retrospectively analyzed. The outcomes and frequencies of the elbow metastatic and primary malignancies were evaluated. Data were collected from patients' medical and radiological documents, and a dedicated archive was created for this study.

RESULTS

Most tumors occurred on the right side and were intra-articular or distal to the humerus. A total of 75.8% (25/33) of the patients had tumors of any diameter ≥5 cm. Most patients were treated with extensive resection. A total of 81.8% (27/33) of the patients had wide resected tumor margins, and 18.2% (6/33) had intralesional tumor margins. The median follow-up was 42 (range, 1 to 83) months. Synovial sarcoma and malignant peripheral nerve sheath tumors were the most common soft tissue sarcomas, and pulmonary adenoma and multiple myeloma were found in metastatic lesions.

CONCLUSION

Elbow surgery is particularly challenging due to the interrelationship of major neurovascular structures. Synovial sarcoma and malignant peripheral nerve sheath tumors are the most common soft tissue sarcomas, and pulmonary adenoma and multiple myeloma are found in metastatic lesions. Limb-sparing surgery is the gold-standard method recently.

摘要

目的

本研究旨在探讨肘周原发和转移性恶性肿瘤的病因分布,以及手术和辅助治疗对临床结果的影响。

方法

回顾性分析了 2006 年 1 月至 2020 年 12 月期间共 33 例接受手术治疗且有或无临床治疗的肘肿瘤患者(男性 15 例,女性 18 例;中位年龄:55 岁;范围:39-71 岁)的病历资料。评估了肘转移性和原发性恶性肿瘤的结局和发生频率。数据来自患者的医疗和影像学文件,并为此研究创建了一个专门的档案。

结果

大多数肿瘤发生在右侧,位于关节内或肱骨远端。75.8%(25/33)的患者有任何直径≥5cm 的肿瘤。大多数患者接受了广泛切除。81.8%(27/33)的患者肿瘤切缘广泛,18.2%(6/33)的患者肿瘤切缘为腔内。中位随访时间为 42(范围:1-83)个月。滑膜肉瘤和恶性外周神经鞘瘤是最常见的软组织肉瘤,而转移性病变中发现了肺腺癌和多发性骨髓瘤。

结论

由于主要的神经血管结构相互关系,肘手术特别具有挑战性。滑膜肉瘤和恶性外周神经鞘瘤是最常见的软组织肉瘤,而肺腺癌和多发性骨髓瘤是转移性病变中发现的肿瘤。保肢手术是最近的金标准方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/811b/11411880/440065300142/JDRS-2024-35-3-628-636-F1.jpg

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