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Is frozen tumour-bearing autograft with concurrent vascularized fibula an alternative to the Capanna technique for the intercalary reconstruction after resection of osteosarcoma in the lower limb?

冷冻荷瘤自体移植联合吻合血管的腓骨是下肢骨肉瘤切除术后插入重建的Capanna技术的替代方法吗?

  • 影响因子:3.58
  • DOI:10.1302/0301-620X.102B5.BJJ-2019-1380.R1
  • 作者列表:"Lu Y","Zhu H","Huang M","Zhang C","Chen G","Ji C","Wang Z","Li J
  • 发表时间:2020-05-01
Abstract

AIMS:The use of frozen tumour-bearing autograft combined with a vascularized fibular graft (VFG) represents a new technique for biological reconstruction of massive bone defect. We have compared the clinical outcomes between this technique and Capanna reconstruction. METHODS:From June 2011 to January 2016 a retrospective study was carried out of patients with primary osteosarcoma of lower limbs who underwent combined biological intercalary reconstruction. Patients were categorized into two groups based on the reconstructive technique: frozen tumour-bearing autograft combined with concurrent VFG (Group 1) and the Capanna method (Group 2). Demographics, operating procedures, oncological outcomes, graft union, limb function, and postoperative complications were compared. RESULTS:A total of 23 patients were identified for analysis: eight in Group 1 and 15 in Group 2. There was no difference in the demographics (age, sex, and affected site) and operating procedures (resection length, duration of surgery, and blood loss) between the two groups. No significant difference was found in local recurrence in Group 1 versus Group 2 (p = 0.585). Mean union time for the frozen autograft-host junction was 8.4 months (7.0 to 11.0), significantly earlier than for the allograft-host junction in Group 2 (mean 14.1 months (10.0 to 28.0); p < 0.001). Mean Musculoskeletal Tumor Society scores in groups 1 and 2 were 90.3% (SD 7.4%) and 88.0% (SD 9.0%), respectively, with no significant statistical difference (p = 0.535). In terms of complications, infection (n = 1, 6.7%) and delayed union (n = 2, 13.3%) occurred in Group 2, but no such complications were observed in Group 1. CONCLUSION:Frozen tumour-bearing autograft in combination with VFG can be used as an alternative to the Capanna reconstruction in properly selected patients with osteosarcoma. Cite this article: Bone Joint J 2020;102-B(5):646-652.

摘要

目的: 冷冻荷瘤自体移植联合带血管腓骨移植 (VFG) 代表了一种生物重建大块骨缺损的新技术。我们比较了这种技术和Capanna重建的临床结果。 方法: 回顾性研究 2011 年 6 月至 2016 年 1 月接受联合生物支架重建的原发性下肢骨肉瘤患者。根据重建技术将患者分为两组: 冷冻荷瘤自体移植物联合并发VFG (组 1) 和Capanna方法 (组 2)。比较人口统计学、操作程序、肿瘤学结果、移植物愈合、肢体功能和术后并发症。 结果: 共确定 23 例患者进行分析: 组 1 8 例,组 2 15 例。两组患者的人口统计学 (年龄、性别和受累部位) 和手术操作 (切除长度、手术持续时间和失血量) 无差异。未发现组 1 与组 2 的局部复发有显著差异 (p = 0.585)。冷冻自体移植物-宿主连接的平均愈合时间为 8.4 个月 (7.0 ~ 11.0),组 2 中显著早于同种异体移植物-宿主连接 (平均 14.1 个月 (10.0 ~ 28.0); p <0.001)。组 1 和组 2 的平均肌肉骨骼肿瘤社会评分分别为 90.3% (SD 7.4%) 和 88.0% (SD 9.0%),无显著统计学差异 (p = 0.535)。在并发症方面,2 组发生感染 (n = 1,6.7%) 和延迟愈合 (n = 2,13.3%),但 1 组未观察到此类并发症。 结论: 在适当选择的骨肉瘤患者中,冷冻荷瘤自体移植联合VFG可作为Capanna重建的替代方法。引用本文: 骨关节J 2020;102-B(5):646-652。

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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