由于局部骨髓瘤复发而引起的多层血管束的封闭,用广泛切除和血管重建来治疗
Joao Vale1, Sara Diniz1, Carlos Pereira2
1Department of Orthopaedics, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
概括
这项案例研究表明,对于复发性骨髓瘤来说,肢体救援是可能的. 血管重建技术可以在复杂的骨肉瘤手术后保持下肢功能.
科学领域:
- 整形瘤学 整形瘤学
- 血管外科 血管外科
- 肌肉骨瘤学 肌肉骨瘤学
背景情况:
- 骨髓瘤是最常见的原发性骨癌.
- 骨髓瘤局部复发,特别是在肢体节约手术后,预后不好.
- 在先前重建的四肢中,复发性骨髓瘤的管理策略尚未明确.
研究的目的:
- 描述一个复发性常规骨髓瘤在骨的病例.
- 为了说明广泛局部复发的手术管理涉及主要的骨血管.
- 通过结合骨和血管重建来突出肢体救援的可能性.
主要方法:
- 循环切除复发性骨髓瘤,包围着骨血管束.
- 肢体救援手术涉及到使用聚四乙烯 (PTFE) 移植的尾静脉的旁路重建.
- 动脉重建使用对侧沙芬静脉移植.
主要成果:
- 成功地对复发性瘤进行了封锁切除.
- 通过假体和自主移植恢复尾血管流动.
- 实现了下肢功能的保存.
结论:
- 在先前重建的肢体中,局部复发性骨髓瘤的管理需要个性化的方法.
- 肢体救援手术即使在涉及神经血管结构的广泛局部复发的情况下也是可行的.
- 结合骨和血管重建技术对于在复杂的肌肉骨肉瘤病例中保持肢体功能至关重要.
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