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在瘤 iliosacral 切除之后的重建

Samuel E Broida¹, Kim M Tsoi^2,3, Peter S Rose¹

¹Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

The bone & joint journal

|December 31, 2023

概括

在切除后重建关节 (SIJ) 没有提供功能益处,并且增加了感染和更长的手术等风险. 没有重建的患者表现出相似的结果,这表明重建可能不需要.

科学领域:

整形外科手术整形外科手术
骨瘤学骨瘤学
重建性手术是一种重建性手术.

背景情况:

圣关节 (SIJ) 对于轴骨架和下肢连接至关重要.
在 iliosacral 切除后进行SIJ重建的必要性受到争论.
有限的数据存在,比较了重建与非重建SIJ患者的结果.

研究的目的:

为了比较经过神经关节 (SIJ) 重建的患者和经过 iliosacral 切除后没有正式重建的患者之间的结果.
评估SIJ重建对功能结果,并发症和生存率的影响.

主要方法:

一个回顾性回顾60名接受了 iliosacral 切除的患者,其中27人接受了重建,33人没有.
收集的数据包括瘤特征,手术细节,并发症,功能评分 (肌肉骨瘤协会评分) 和生存率.
对于幸存的患者,随访时间平均为9年.

主要成果:

在重建和非重建组之间,疾病特异性生存率或转移率没有显著差异.
重建与显著延长的操作时间,增加的输血需求和更高的深层感染率 (48%对12%) 相关.
功能性结果,包括行走和肌肉骨瘤学会得分,在两组之间都是相似的.

结论:

骨关节切除后的骨关节 (SIJ) 重建与增加的手术时间,失血和感染风险有关.
与非重建相比,正式的SIJ重建似乎没有改善功能结果或生存率.
这些发现表明,在 iliosacral 切除后,可能不需要常规SIJ重建.

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