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目的初步观察原位微波灭活+肿瘤假体置换的近期临床疗效,探讨原位微波灭活+肿瘤假体置换在四肢肿瘤保肢手术中的应用价值。方法 2008年1月～2012年1月采用原位微波灭活+肿瘤假体置换方法治疗四肢近关节肿瘤5例,其中骨肉瘤4例,骨转移瘤1例;4例骨肉瘤Enneking分期:ⅡA期3例,ⅡB期1例。结果平均随访17个月,死亡2例,术后生存期分别为7和29个月,1例骨转移瘤患者术后带瘤生存。无局部复发,无假体周围感染、松动及断裂事件发生。术后6个月以上进行功能评分,优2例,良2例,中1例,Enneking得分平均21分。结论原位微波灭活+肿瘤假体置换在不增加局部复发机会和假体松动等并发症的前提下,可以保留更多骨量,为更多软组织覆盖及远期假体翻修等处置提供更多的机会和选择余地,是一种可行的手术方式,远期效果有待进一步观察。
Objective To observe the clinical efficacy of in-situ microwave inactivation and tumor prosthesis replacement and investigate the value of in-situ microwave inactivation and tumor prosthesis replacement in salvage limb salvage surgery. Methods From January 2008 to January 2012, 5 cases of near-joint tumors of limbs were treated by in-situ microwave inactivation and tumor prosthesis replacement, including 4 osteosarcoma and 1 bone metastasis, and 4 cases of osteosarcoma Enneking stage ⅡA 3 cases, Ⅱ B period in 1 case. Results The patients were followed up for an average of 17 months with 2 deaths. The postoperative survival rates were 7 and 29 months respectively. One patient with bone metastases survived after surgery. No local recurrence, no infection around the prosthesis, loosening and fracture occurred. The functional scores were performed more than 6 months after surgery, 2 were excellent, 2 were good, 1 was fair, and the Enneking score was 21 on average. Conclusion In-situ microwave inactivation and tumor prosthesis replacement can preserve more bone mass without additional complications such as local recurrence and loosening of prosthesis, and provide more treatment for more soft tissue covering and revision of long-term prosthesis More opportunities and options, is a viable surgical approach, the long-term results need to be further observed.