PDF(Pubmed)
Abstract：
Background: Primary malignant bone tumors are most commonly associated with mutilating surgical procedures that can significantly disturb the motor development of a young patient and are frequently affiliated with major postoperative complications. Unfortunately, despite available autologous tissue donor sites, artificial materials are still most commonly used for the reconstruction of post-resection defects. Reconstructive microsurgery is increasingly recognized as an effective method of functional reconstruction, creating the possibility of performing limb-sparing surgery (LSS) with significant limitation of major postoperative complications at the same time. Methods: The study group consisted of 9 pediatric patients diagnosed with primary malignant bone tumor in the limb location. In order to perform microvascular reconstruction, 9 free fibula flaps were used in combination with a bone allograft (Capanna method). The functional outcome of the reconstruction was assessed on the basis of the MSTS (Musculoskeletal Tumor Society Scoring System) scale. Results: The presented analysis proves the effectiveness of this reconstructive procedure and the possibility of performing LSS with reasonable functional outcomes after appropriate patient qualification. In this study, all limbs included were spared. In all cases, the R0 surgical margins were achieved and no reports of local recurrences were reported during the follow-up. The average score on the MSTS scale was 27/30 points. Conclusions: Microvascular reconstructive surgery is an individually personalized and highly effective method of treating patients with primary bone tumors in the limb location and provides satisfactory functional outcomes.
摘要：
背景：原发性恶性骨肿瘤最常见的是与残缺的外科手术程序有关，这些手术程序可能会严重干扰年轻患者的运动发育，并且经常与主要的术后并发症有关。不幸的是,尽管有可用的自体组织供体部位，人工材料仍然最常用于切除后缺损的重建。重建显微外科手术越来越被认为是一种有效的功能重建方法，创造了进行保肢手术（LSS）的可能性，同时显着限制了主要的术后并发症。方法：研究组包括9例诊断为四肢原发性恶性骨肿瘤的小儿患者。为了进行微血管重建，9个游离腓骨皮瓣与同种异体骨移植（Capanna方法）结合使用。根据MSTS（肌肉骨骼肿瘤协会评分系统）量表评估重建的功能结果。结果：所提出的分析证明了这种重建程序的有效性，以及在适当的患者资格后以合理的功能结果进行LSS的可能性。在这项研究中,包括所有肢体都幸免。在所有情况下,获得了R0手术切缘,随访期间未报告局部复发.MSTS量表的平均得分为27/30分。结论：微血管重建手术是治疗四肢原发性骨肿瘤患者的个性化和高度有效的方法，并提供令人满意的功能结果。
