保留关节的干骺端骨肉瘤切除手术

Surgical resection of osteosarcoma at the metaphysis with joint preservation.

目的 介绍一种保留关节的肢体干骺端骨肉瘤切除手术。方法 对8例肢体骨肉瘤患者进行了保留关节的瘤骨节段切除酒精灭活再植入手术,术前和术后化疗采用HDMTX-VCR-ADM方案。平均随访时间38.4月。结果 2例因术后肺转移死亡,1例局部复发。2例内固定发生松动、断裂。6例病损在下肢的患者,患肢活动度均恢复正常;2例病损在肱骨上段者,术后亦有较好的活动度。骨骺未闭合者患肢均无明显短缩。结论 对于肢体骨肉瘤患者,应充分考虑其保留关节的可能性。手术前仔细分析影像资料,对手术方案的选择意义重大。

Objective To introduce a surgical procedure for removal of metaphyseal osteosarcoma. Methods Eight cases of osteosarcoma were treated by surgical removal with preservation of adjacent joint,and adjuvant chemotherapy with HDMTX - VCR - ADM was instituted at the pre - and post - operative periods. All patients were followed - up for 38.4 months.Results Two patients died of metastasis and 1 patient had local recurrence and 2 patients had loosening of the internal fixation device. Limb function of all patients were resumed satisfactorily. Conclusion The possibility of preserving of the joint should be considered as fully as possible, and it is important to have a sophisticated analysis of the radiographic data before operation for the selection of a proper surgical procedure.