Ali Sheikh Muhammad Ebad, Fatima Syeda Safeena, Munawar Bisma, Fatima Maheen, Naqvi Syeda Kisa Batool, Malik Laiba Urooj
Departamento de Emergência, Mamji Hospital, Karachi, Paquistão.
Karachi Medical and Dental College, Karachi, Paquistão.
Rev Bras Ortop (Sao Paulo). 2024 Dec 21;59(6):e830-e838. doi: 10.1055/s-0044-1779321. eCollection 2024 Dec.
Surgical procedures of curettage and surgical resection are used to treat giant cell tumor (GCT) of the distal radius, but it is still controversial whether one provides better functional outcomes than the other. The present study aims to determine and compare both procedures regarding complications, local recurrence, and mobility. A complete search of the applicable literature was done and independently assessed by three authors. Included studies reported on patients who were surgically treated for GCT of the distal radius with either curettage or surgical resection. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was used to obtain research regarding outcomes of surgical resection and curettage for GCT of the distal radius. A meta-analysis was performed using this data. Quality assessment was performed. Seven studies, comprising 114 patients with resection and 108 with curettage, totaling 222 subjects with 117 males and 105 females, were included in the present review. Overall, patients in the curettage group had a higher recurrence rate (0.205; 95% confidence interval [95%CI] = 0.057-0.735; = 0.015). Incidences in complications remains the same in both groups (2.845; 95%CI = 0.644-12.57; = 0.168). Incidences in functional outcomes were the same in both groups as well (-0.948; 95%CI = -2.074-0.178; = 0.099). The authors prefer resection and reconstruction for GCT of distal radius as optimum treatment method due to the similar functional outcomes and lower chances of recurrence. Curettage might be a treatment option in low-grade GCT coupled with adjuvant, neoadjuvant or ablation to reduce the risk of recurrence.
刮除术和手术切除等外科手术方法用于治疗桡骨远端骨巨细胞瘤(GCT),但哪种方法能带来更好的功能预后仍存在争议。本研究旨在确定并比较这两种手术方法在并发症、局部复发和活动度方面的差异。三名作者对相关文献进行了全面检索并独立评估。纳入的研究报告了接受刮除术或手术切除治疗桡骨远端GCT的患者情况。采用系统评价和Meta分析的首选报告项目(PRISMA)声明来获取关于桡骨远端GCT手术切除和刮除术预后的研究。利用这些数据进行了Meta分析,并进行了质量评估。本综述纳入了7项研究,共222名受试者,其中114例行切除术,108例行刮除术,男性117例,女性105例。总体而言,刮除术组患者的复发率更高(0.205;95%置信区间[95%CI] = 0.057 - 0.735;P = 0.015)。两组并发症的发生率相同(2.845;95%CI = 0.644 - 12.57;P = 0.168)。两组功能预后的发生率也相同(-0.948;95%CI = -2.074 - 0.178;P = 0.099)。由于功能预后相似且复发几率较低,作者更倾向于将桡骨远端GCT的切除和重建作为最佳治疗方法。刮除术可能是低级别GCT的一种治疗选择,并结合辅助、新辅助或消融治疗以降低复发风险。