scholarly journals Autoclaved Tumor Bone for Skeletal Reconstruction in Paediatric Patients: A Low Cost Alternative in Developing Countries

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Masood Umer ◽  
Hafiz Muhammad Umer ◽  
Irfan Qadir ◽  
Haroon Rashid ◽  
Rabia Awan ◽  
...  
Keyword(s):  
Developing Countries ◽  
Malignant Tumors ◽  
Low Cost ◽  
En Bloc Resection ◽  
Bony Union ◽  
Functional Evaluation ◽  
En Bloc ◽  
Musculoskeletal Tumor ◽  
Non Union ◽  
Wound Debridement

We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1) wide en bloc resection of the tumor; (2) curettage of tumor from the resected bone; (3) autoclaving for 8 minutes (4) bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used); (5) reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months), 31 patients had recovered without any complications. Thirty-eight patients successfully achieved a solid bony union between the graft and recipient bone. Three patients had surgical site infection. They were managed with wound debridement and flap coverage of the defect. Local recurrence and nonunion occurred in two patients each. One patient underwent disarticulation at hip due to extensive local disease and one died of metastasis. For patients with non-union, revision procedure with bone graft and compression plates was successfully used. The use of autoclaved tumor grafts provides a limb salvage option that is inexpensive and independent of external resources and is a viable option for musculoskeletal tumor management in developing countries.

scholarly journals Complication avoidance in the treatment of malignant tumors of the skull base

2002 ◽  
Vol 12 (5) ◽  
pp. 1-6 ◽  
Author(s):  
James T. Kryzanski ◽  
Donald J. Annino ◽  
Carl B. Heilman
Keyword(s):  
Skull Base ◽  
Malignant Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Surgical Approaches ◽  
High Complication Rate ◽  
En Bloc ◽  
Complications Of Surgery ◽  
Skull Base Lesions ◽  
Skull Base Defects

The treatment of malignant skull base tumors has improved with the development of skull base surgical approaches that allow en bloc resection of a lesion and increase the efficacy of adjuvant therapies. The anatomical complexity of these lesions and their surroundings has led to a relatively high complication rate. Infection and cerebrospinal fluid fistulas are the most common serious procedure-related complications. They result from the frequent necessity of working in a contaminated space such as the paranasal sinuses as well as from the creation of large dural and skull base defects. The authors have reviewed the literature regarding complications of surgery for malignant skull base lesions and present several techniques and strategies for minimizing their incidence by performing the craniofacial approach to anterior skull base lesions.

scholarly journals Advantages of the open approach in sinonasal tract tumors with midfacial and suprastructure invasion

2020 ◽  
Vol 10 (37) ◽  
pp. 30-34 ◽  
Author(s):  
Daniela Vrinceanu ◽  
Bogdan Banica ◽  
Mihai Dumitru ◽  
Gabriela Musat
Keyword(s):  
Frontal Sinus ◽  
Malignant Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Open Approach ◽  
External Approach ◽  
En Bloc ◽  
Orbital Wall ◽  
Midfacial Degloving ◽  
And Control

AbstractBACKGROUND. In case of rhinosinusal malignant tumors, it is important to have a unified and simple terminology. The suprastructure refers to the ethmoid sinus, the sphenoid sinus, the frontal sinus and the olfactory area of the nose. The mesostructure includes the maxillary sinus, excepting the orbital wall, and the respiratory part of the nose.MATERIAL AND METHODS. We will present two clinical cases admitted and surgically treated in our department. The first one is a left-side suprastructure mass in a 39-year-old male patient, with a particular evolution. The second one is a left-side midfacial and suprastructure tumor with 3 prior negative biopsies in a 57-year-old patient. In both cases, we performed an external surgical approach.DISCUSSIONS. For an external approach in mesostructure malignant tumors, we propose a combined approach using lateral nasal rhinotomies, sub-labial rhinotomies and midfacial degloving. The external approach in malignant tumors of the supra-structure is centred on a classical incision for the frontal sinus or a hemicoronal or coronal approach. There are some clear advantages of the open approach to be considered.CONCLUSION. The advantages of the external approach are represented by a direct visualization and control of the tumor during the ablative time; a better control for negative margins; a better control of haemostasis; a better chance for en-bloc resection versus piece-meal resection.

En bloc petrosectomy for malignant tumors involving the external auditory canal and middle ear: surgical methods and long-term outcome

2008 ◽  
Vol 108 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Takeshi Okada ◽  
Kiyoshi Saito ◽  
Masakatsu Takahashi ◽  
Yasuhisa Hasegawa ◽  
Yasushi Fujimoto ◽  
...  
Keyword(s):  
Inner Ear ◽  
Middle Ear ◽  
External Auditory Canal ◽  
Malignant Tumors ◽  
Petrous Bone ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Brain Invasion ◽  
Surgical Methods

Object The aim of this study was to describe a method for resecting malignant tumors originating in the external auditory canal or middle ear and requiring en bloc resection of the petrous bone. Methods Between 1995 and 2005, the authors performed en bloc petrosectomy for 18 malignant tumors in 9 male and 9 female patients, ranging in age from 15 to 74 years. Fourteen tumors originated in the external ear, 2 in the middle ear, and 2 in the parotid gland. The pathological entities included 15 squamous cell carcinomas, 2 adenoid cystic carcinomas, and 1 rhabdomyosarcoma. Through an L-shaped temporosuboccipital craniotomy, a medial osteotomy was created through the inner ear for tumors without extension into the inner ear (14 cases) and through the tip of the petrous bone for tumors reaching the inner ear (4 cases). Temporal dura mater in 3 patients and the base of the temporal lobe in 2 patients were included in the en bloc resection. Results Surgical complications occurred in 5 patients (28%) with no deaths. During a mean follow-up period of 45 months, 3 patients died of tumor recurrence. Overall, 2- and 5-year survival rates were 86 and 78%, respectively. Two of three patients with dural extension and 1 of 2 with brain invasion remain alive. Two of four patients with tumor extension into the inner ear died. Conclusions En bloc petrosectomy is recommended for malignant tumors of the ear. It is safe and effective for lesions limited to the middle ear and may be the procedure of choice for tumors reaching the inner ear and those with dural or brain invasion.

scholarly journals Wide En Bloc Resection for Primary Malignant Tumors of Long Bone

1977 ◽  
Vol 26 (4) ◽  
pp. 500-503
Author(s):  
H. Ikuta ◽  
T. Goto ◽  
N. Koga ◽  
Y. Shirahama
Keyword(s):  
Malignant Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Long Bone ◽  
En Bloc

scholarly journals Outstanding issues of surgical treatment of locally advanced forms of malignant tumors

2020 ◽  
Vol 21 (4) ◽  
pp. 269-274
Author(s):  
V.V. Egorenkov ◽  
K.A. Andreychuk ◽  
M.S. Molchanov ◽  
E.V. Kuleshova
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Locally Advanced ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Considerable Uncertainty ◽  
Histological Factors ◽  
The Right ◽  
Complete Tumor

Nowadays surgery is still the mainstay of solid tumors treatment. En Bloc resection is surgical treatment in amount of complete tumor removal. There remains considerable uncertainty about many aspects of resection boundaries, including definition and influence of anatomical and histological factors. One of the biggest challenges for the surgeon is choosing the right surgery for the «right» patient, taking into account the type of tumor and its biology.

scholarly journals En bloc resection of skull base malignant tumors. Results of resection with dura or brain.

1998 ◽  
Vol 24 (3) ◽  
pp. 316-319
Author(s):  
Kiyoshi SAITO ◽  
Jun YOSHIDA ◽  
Masakatsu TAKAHASHI ◽  
Takashi HASEGAWA ◽  
Keizo FUKUTA
Keyword(s):  
Skull Base ◽  
Malignant Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc

scholarly journals A Case Report of Proximal Migration of Fibular Head with Intact Peroneal Nerve in a Post-Operative Infected Tibia Gap Non-union Managed by Ilizarov Technique

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Spandan R Koshire ◽  
Rajesh R Koshire ◽  
Ajay M Wankhade
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Fracture Site ◽  
Bony Union ◽  
Ilizarov Technique ◽  
Fibular Head ◽  
Non Union ◽  
Wound Debridement ◽  
Proximal Migration

Introduction: We hereby present a rare case of proximal fibular head migration associated with Ilizarov technique for infected tibia gap non-union due to follow-up failure in post-operative management during the coronavirus disease (COVID) pandemic. Case Report: A 45-year-old male patient had undergone primary external fixation with wound debridement for a compound tibia shaft fracture Grade 3 A Gustilo class which later on with a healed external wound with a discharging sinus at the fracture site was confirmed to be infected non-union and subsequently managed by Ilizarov ring fixation over an antibiotic coated intramedullary nail and local gentamycin beads after a necrotic bone fragment of around 6 cm was excised. Post-operative protocol of compression and distraction was initiated and the patient educated regarding the same before discharge. As the world over was hit by the COVID pandemic and the lockdown limited all possible movements in our country, the patient could not follow up for monitoring the Ilizarov limb lengthening procedure. He presented to us after 4 months after the relaxation of lockdown with radiological union at the docking site but with a shortening of about 3 cm. Vigorous knee range physiotherapy failed to improve range beyond 90° which prompted us to check X-ray the knee joint and revealed the complication of proximal fibular head migration of 4 cm but with no neurodeficit and currently the patient is being managed with full weight mobilization with the help of crutch and shoe raise and an improved knee range till 100° of flexion with no pain tenderness or any other complaints. Conclusion: Having knowledge of this possible rare complication and the need for follow-up and monitoring with the importance of patient education makes practicing orthopedic surgeons equipped to handle and anticipate such undesirable complications. Keywords: Bony union, fibula migration, fibula resection, Ilizarov technique, infected non-union.

Lateral Malleolus En Bloc Resection and Ankle Reconstruction for Malignant Tumors

2005 ◽  
Vol &NA; (437) ◽  
pp. 209-218 ◽  
Author(s):  
Panayiotis J Papagelopoulos ◽  
Olga D Savvidou ◽  
Andreas F Mavrogenis ◽  
Evanthia C Galanis ◽  
William J Shaughnessy ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Lateral Malleolus ◽  
En Bloc
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