Abstract：
OBJECTIVE: The recurrence rate following the excision of tenosynovial giant cell tumors (TSGCT) of the hand is very high. Intraoperative application of a surgical microscope has been reported. However, to date, there are no reports of medium-term outcomes related to this technique. This study aimed to evaluate the medium-term outcomes of tumor excision using surgical microscope for TSGCT of the hand.
METHODS: A total of 27 patients, who underwent an initial surgery for histologically-confirmed TSGCT of the hand, between 2008 and 2020, were included and evaluated. The mean follow-up time postoperatively was 6.8 years. Tumor recurrence and preoperative tumor characteristics were assessed.
RESULTS: All tumors were adherent to tendons, tendon sheaths, neurovascular structures or periarticular ligaments and capsules. Bony lesions were observed in 11 tumors. The surgical microscope was used in 13 tumors. Recurrences were observed in three tumors (overall recurrence rate: 11%). Tumor characteristics were similar in both groups, but the recurrence rate in the group treated using the surgical microscope was 0%, whereas the recurrence rate in the group treated without the surgical microscope was 21%. Re-operations using the surgical microscope for recurrent tumors were performed, without recurrence postoperatively.
CONCLUSIONS: Among patients with TSGCT of the hand treated with tumor excision using the surgical microscope, the postoperative recurrence rate was 0%. Based on the results of this study, the surgical microscope might be used for excision of TSGCTs of the hand.
METHODS: A total of 27 patients, who underwent an initial surgery for histologically-confirmed TSGCT of the hand, between 2008 and 2020, were included and evaluated. The mean follow-up time postoperatively was 6.8 years. Tumor recurrence and preoperative tumor characteristics were assessed.
RESULTS: All tumors were adherent to tendons, tendon sheaths, neurovascular structures or periarticular ligaments and capsules. Bony lesions were observed in 11 tumors. The surgical microscope was used in 13 tumors. Recurrences were observed in three tumors (overall recurrence rate: 11%). Tumor characteristics were similar in both groups, but the recurrence rate in the group treated using the surgical microscope was 0%, whereas the recurrence rate in the group treated without the surgical microscope was 21%. Re-operations using the surgical microscope for recurrent tumors were performed, without recurrence postoperatively.
CONCLUSIONS: Among patients with TSGCT of the hand treated with tumor excision using the surgical microscope, the postoperative recurrence rate was 0%. Based on the results of this study, the surgical microscope might be used for excision of TSGCTs of the hand.
摘要：
目的：手部腱鞘膜巨细胞瘤（TSGCT）切除术后的复发率很高。已经报道了手术显微镜的术中应用。然而,到目前为止,没有与该技术相关的中期结局报告.本研究旨在评估使用TSGCT手部手术显微镜切除肿瘤的中期结果。
方法：共27例患者，他接受了经组织学证实的手部TSGCT的初步手术，在2008年至2020年期间，纳入并进行了评估。术后平均随访时间为6.8年。评估肿瘤复发和术前肿瘤特征。
结果：所有肿瘤均粘附于肌腱，肌腱鞘,神经血管结构或关节周围韧带和囊。在11个肿瘤中观察到骨病变。手术显微镜用于13个肿瘤。在三个肿瘤中观察到复发（总复发率：11％）。两组的肿瘤特征相似，但用手术显微镜治疗组的复发率为0%，而未使用手术显微镜治疗组的复发率为21％。使用手术显微镜对复发性肿瘤进行再次手术，术后无复发。
结论：在使用手术显微镜切除肿瘤的手部TSGCT患者中，术后复发率为0%。根据这项研究的结果，手术显微镜可用于手的TSGCT切除。
方法：共27例患者，他接受了经组织学证实的手部TSGCT的初步手术，在2008年至2020年期间，纳入并进行了评估。术后平均随访时间为6.8年。评估肿瘤复发和术前肿瘤特征。
结果：所有肿瘤均粘附于肌腱，肌腱鞘,神经血管结构或关节周围韧带和囊。在11个肿瘤中观察到骨病变。手术显微镜用于13个肿瘤。在三个肿瘤中观察到复发（总复发率：11％）。两组的肿瘤特征相似，但用手术显微镜治疗组的复发率为0%，而未使用手术显微镜治疗组的复发率为21％。使用手术显微镜对复发性肿瘤进行再次手术，术后无复发。
结论：在使用手术显微镜切除肿瘤的手部TSGCT患者中，术后复发率为0%。根据这项研究的结果，手术显微镜可用于手的TSGCT切除。
