Abstract:
<b>Introduction:</b> Giant cell tumor of the tendon sheath is the most common benign proliferative lesion involving the upper limb, characterized by relatively high recurrence rate after surgery. <br><b>Aim:</b> The objective of the study was a retrospective analysis of outcomes of the operative treatment of these tumors, in a longterm (a mean of 4,2 year) follow-up. <br><b>Material and methods:</b> Preoperative examination was performed in 58 patients, 36 females (62%) and 22 males (38%), in a mean age of 41 years, and treatment outcomes were assessed in 47 persons (81% of the operated patients), at a mean of 4.2-year follow-up. The final assessment was performed in a form of phone interview. <br><b>Results:</b> The most common site of the tumors was the fingers - 42 cases (72%). In 31 patients (53%) the lesion had a well-defined capsule, and in 11 (19%) a satellite nodule was found around the main tumor. A total of 9 relapses (21%) occurred, all within the first 2 years following surgery. Two patients had a next episode of recurrence after the second operation. In 8 out of the 9 patients with a recurrence, the primary lesion did not have a well-defined capsule. In 38 patients who had no relapse, 31 were completely symptom-free, whereas 7 complained of mild pain of the scar and/or numbness of a part of the involved finger. <br><b>Conclusions:</b> The main factor that impacted the high rate of recurrence was incomplete tumor excision, which resulted from inadequately accurate surgery and the tumor morphology (having no well-defend capsule). The role of operating with the use of magnifying devices and keeping a greater surgical margin at resection of the non-capsulated lesions was emphasized, as it could translate into reducing the recurrence rate.
摘要:
<b>简介:</b>腱鞘巨细胞瘤是累及上肢最常见的良性增生性病变,术后复发率相对较高。<br><b>目的:</b>本研究的目的是对这些肿瘤的手术治疗结果进行回顾性分析,长期(平均4,2年)随访。<br><b>材料与方法:</b>对58例患者进行术前检查,36名女性(62%)和22名男性(38%),平均年龄41岁,47人(81%的手术患者)评估了治疗结果,平均随访4.2年。最终评估是以电话采访的形式进行的。<br><b>结果:</b>肿瘤最常见的部位是手指-42例(72%)。在31例患者(53%)中,病变有明确的包膜,在11例(19%)中,在主要肿瘤周围发现了卫星结节。共发生9次复发(21%),都在手术后的头两年内。两名患者在第二次手术后再次复发。9例复发患者中有8例,原发病灶没有明确的包膜.在38名没有复发的患者中,31人完全无症状,而7人抱怨疤痕轻度疼痛和/或受累手指的一部分麻木。<br><b>结论:</b>影响高复发率的主要因素是肿瘤切除不全,这是由于手术和肿瘤形态不够准确(没有很好的防御胶囊)。强调了使用放大装置进行手术并在切除非包膜病变时保持更大的手术切缘的作用。因为它可以转化为降低复发率。