scholarly journals Modular endoprosthetic replacement for proximal tibia tumor patients

2021 ◽  
Vol 23 (2) ◽  
pp. 242-249
Author(s):  
O. Ye. Vyrva ◽  
I. O. Skoryk ◽  
V. D. Tovazhnianska
Keyword(s):  
Surgical Treatment ◽  
Tumor Recurrence ◽  
Proximal Tibia ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Bone Allograft ◽  
Functional Results ◽  
Limb Salvage Surgery ◽  
Endoprosthetic Replacement ◽  
Modular Endoprosthesis

The major method of malignant bone tumors treatment is surgery. The most important task of an orthopedic surgeon is to preserve an adjacent joint. Currently, there are a large number of various reconstructive surgeries, including structural bone allograft, allocomposite and modular endoprosthetics replacement. The aim: to analyze the results of surgical treatment for proximal tibia malignant tumors using modular endoprosthesis. Materials and methods. The results of proximal tibia (PT) modular endoprosthetic replacement in 48 patients with PT tumor lesions were evaluated. The patients were divided into two groups: I (n = 36) – tumor resection and primary modular endoprosthesis, II (n = 12) – revision modular endoprosthetic replacement due to complications. Complications were divided into oncological, mechanical and non-mechanical. The functional outcomes were measured using the MSTS and TESS scores. Results. During the treatment, 10 (21.2 %) patients underwent myofascioplastic amputation at the middle third of the thigh: due to periprosthetic infection – 8 people and tumor recurrence – 2. It was found that the patients got back to regular way of life on average in 2.0–2.5 months. Functional results on the MSTS score were 73 ± 12 %, on the TESS score – 74 ± 16 %, which corresponds to good functional results. Among the patients, who underwent limb salvage surgery, no tumor recurrence was detected during a follow-up period from 6 months up to 11 years. Conclusions. The choice of surgical treatment depends on the size of tumor, its location, pathohistomorphological picture, age, presence of pathological fractures, vascular and nerve tumor invasion. The use of modern designs of PT modular tumor endoprostheses and perfect surgeries makes it possible to minimize complications.

scholarly journals RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH BENIGN TUMORS OF THE SPINE

2005 ◽  
pp. 061-065
Author(s):  
Dmitry Aleksandrovich Ptashnikov ◽  
Vladimir Dmitryevich Usikov
Keyword(s):  
Surgical Treatment ◽  
Tumor Recurrence ◽  
Plastic Material ◽  
Ct Scanning ◽  
Functional Results ◽  
Punch Biopsy ◽  
Benign Tumors ◽  
Tumor Type ◽  
Primary Tumors ◽  
Technical Problems

Objective. To validate the approach to treatment of patients with primary tumors of the spine. Material and Methods. The experience of surgical treatment of 47 patients with benign tumors of the spine was analyzed. The treatment approach was defined with the account of tumor type and localization, and of patient’s somatic status. The diseased area was examined with the help of X-ray, CT scanning, and MRI, and a punch biopsy in some patients. Results. The tumor recurrence was registered in 6 (14.6 %) patients. This shows that in some cases the exact margins of the tumor were not defined despite the comprehensive diagnostic possibilities. Functional results of the treatment implied the restoration of the spine support ability and the pain regress in all observations. Bone plasty was the method of choice for interbody defect replacement. Conclusion. The radical surgery (corpectomy and spondylectomy) considerably reduces the risk of tumor recurrence. Lumbosacral location of the tumor with paravertebral extension presents serious technical problems in its total removal. Autogenic cortical cancellous bone proved to be a good plastic material for defect replacement after vertebra resection and fusion.

scholarly journals Management of low-grade gliomas

2021 ◽  
Author(s):  
Milla Giancristofaro Dutra ◽  
Bernardo Valle Zanetti ◽  
Ana Luiza Badini Tubenchlak ◽  
Bárbara Gomes Muffato ◽  
Leonardo Moreira Dutra ◽  
...  
Keyword(s):  
Large Scale ◽  
Randomized Clinical Trials ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Progression Free Survival ◽  
Functional Results ◽  
Therapeutic Modality ◽  
Low Grade ◽  
Low Grade Gliomas ◽  
The Central Nervous System

Background: Gliomas are the most aggressive and prevalent primary malignant tumors of the central nervous system. For better mapping, they are subclassified into degrees in proportion to their malignancy. Although low-grade patients have a better prognosis, they are extremely heterogeneous. Since the high variability in the outcomes of the condition, it is essential to investigate the current therapeutic strategies available. Objective: Analyze the management of low-grade gliomas. Methods: In April 2021, a literature review was conducted on MEDLINE using the descriptors: “Glioma”, “Low Grade”; “Treatment”; as well as their variations obtained in MeSH. Controlled and randomized clinical trials carried out on humans in the last five years were included. Results: 63 articles were found and 10 of them were analyzed in this review. The research has shown that total tumor resection is the therapeutic modality that causes the greatest drop in the mortality rates. Furthermore, the greater the extraction, the greater the progression-free survival. In this way, for greater safety of large-scale surgeries, several intraoperative techniques have been developed. An example is the waking approach, which presents favorable long-term functional results and low failure rates. However, the isolated surgery is often not sufficiently curative. Therefore, it is necessary to complement radiotherapy and chemotherapy with temozolomide, associated with a 5 to 10 year survival rate when combined. Conclusions: Studies have shown that total resection of the tumor is the best way to manage low-grade gliomas, but it is often combined with temozolamide chemotherapy and radiotherapy for a better prognosis.

scholarly journals Reconstruction with Total Scapular Reverse Total Shoulder Endoprosthesis after Radical Tumor Excision

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Michael J. Harvey ◽  
Howard G. Rosenthal
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Radical Resection ◽  
Shoulder Girdle ◽  
Shoulder Prosthesis ◽  
Tumor Control ◽  
Limb Salvage Surgery ◽  
Postoperative Function ◽  
Tumor Excision ◽  
Reverse Total Shoulder

Malignant musculoskeletal tumors about the shoulder girdle region involving the scapula are fairly rare, but when diagnosed, challenging and complex surgical treatment may be warranted with the primary goal of improving patient survival. These tumors are typically extensive and infiltrative at the time of presentation, requiring radical resection to achieve margins and obtain local tumor control. Historically, forequarter amputation or flail extremity were the mainstays of treatment in these cases. Presently, with recent advances in diagnostics, imaging, adjuvant therapies, and surgical treatment, many patients presenting with malignant tumors involving the scapula are candidates for limb salvage surgery. Reconstruction with endoprosthesis seems to have gained acceptance as the preferred surgical treatment for such lesions, as this intervention has resulted in improved postoperative function and cosmesis, with an acceptable complication rate. We present our experience with recent advancement in these surgical efforts in the form of shoulder girdle reconstruction with total scapular reverse total shoulder prosthesis after radical tumor excision.

scholarly journals Total Humeral Endoprosthetic Replacement following Excision of Malignant Bone Tumors

Sarcoma ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Suhel Kotwal ◽  
Bryan Moon ◽  
Patrick Lin ◽  
Robert Satcher ◽  
Valerae Lewis
Keyword(s):  
Limb Salvage ◽  
Mechanical Stability ◽  
Malignant Tumors ◽  
Hand Function ◽  
Functional Results ◽  
Shoulder Abduction ◽  
Endoprosthetic Replacement ◽  
Active Flexion ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Humerus is a common site for malignant tumors. Advances in adjuvant therapies and reconstructive methods provide salvage of the upper limb with improved outcomes. Reports of limb salvage with total humeral replacement in extensive humeral tumors are sparse. We undertook a retrospective study of 20 patients who underwent total humeral endoprosthetic replacement as limb salvage following excision of extensile malignant tumor from 1990 to 2011. With an average followup of 42.9, functional and oncological outcomes were analyzed. Ten patients were still alive at the time of review. Mean estimated blood loss was 1131 mL and duration of surgery was 314 minutes. Deep infection was encountered in one patient requiring debridement while mechanical loosening of ulnar component was identified in one patient. Subluxation of prosthetic humeral head was noted in 3 patients. Mean active shoulder abduction was 12.5° and active flexion was 15°. Incompetence of abduction mechanism was the major determinant of poor active functional outcome. Mean elbow flexion was 103.5° with 30.5° flexion contracture in 10 patients with good and useful hand function. Average MSTS score was 71.5%. Total humeral replacement is a reliable treatment option in restoring mechanical stability and reasonable functional results without compromising patient survival, with low complication rate.

scholarly journals Multilevel radical resection in treatment of patients with spine tumors

2021 ◽  
Vol 13 (2) ◽  
pp. 11-17
Author(s):  
R. M. Kabardaev ◽  
E. R. Musaev ◽  
A. K. Valiev ◽  
K. A. Borzov ◽  
S. F. Kuznetsov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Disease Free Survival ◽  
Functional Results ◽  
Radical Resection ◽  
Spinal Tumors ◽  
Benign Tumors ◽  
Study Objective ◽  
Surgical Interventions ◽  
National Medical

Introduction. Radical surgical resections in the treatment of malignant tumors of the spine have proven effective in improving both overall and disease-free survival of patients. Indications for such interventions are primary malignant tumors of the spine, primary benign tumors with aggressive growth, and solitary metastatic lesions in patients with a favorable oncological prognosis. Due to the anatomical features of the vertebral column, it is very difficult to perform radical resections. An even more difficult task is to perform such interventions for multilevel spinal lesions.The study objective is to evaluate the results of radical surgical treatment for multilevel tumor lesions of the spine.Materials and methods. From 2004 to 2019, in the department of spine surgery of the N.N. Blokhin National Medical Research Center of Oncology treated 36 patients with spinal tumors, who underwent multilevel radical resections. The analysis of this surgical treatment of patients with multilevel neoplastic lesions of the spine was carried out.Results. Performing radical surgical interventions on the spine makes it possible to reduce the frequency of local relapses, improve functional results and overall survival of patients. After performing multilevel resections, complications often occur.

scholarly journals Spine osteoid osteoma and osteoblastoma in children: diagnosis and surgical treatment

1996 ◽  
Vol 3 (1) ◽  
pp. 21-27
Author(s):  
A. P. Berezhniy ◽  
A. I. Snetkov ◽  
V. L. Kotov ◽  
A. K. Morozov ◽  
A. V. Baeva
Keyword(s):  
Surgical Treatment ◽  
Clinical Examination ◽  
Osteoid Osteoma ◽  
Tumor Recurrence ◽  
Tumor Resection ◽  
Pathologic Process ◽  
X Ray

The experience of diagnosis and surgical treatment of spine osteoid osteoma and osteoblastoma in 60 patients was presented. In 78% of cases osteoid osteoma was diagnosed before operation, in 36% of cases by X-ray examination, and in 86 % of all patients examined by CT method. Osteoblastoma was diagnosed by clinical examination in 8% of cases, and by CT method in 80% of the examined patients. By morphologic criteria noninvasive osteoblastoma (osteoid osteoma) 33 observations, invasive one 23 observations, malignant (agressive) 2 observations, multifocal one 2 observations were differentiated. The conclusion was drawn that there were various types of single pathologic process, i.e. osteoblastoma. Surgical treatment tumor resection together with surrounding zone of sclerosis, gave the recovery in 95% of cases. Three patients with tumor recurrence refused reoperation, their outcomes were unknown.

scholarly journals Femoral bone growth after extendible endoprosthetic replacement of the proximal tibia in skeletally immature patients

2021 ◽  
Vol 87 (3) ◽  
pp. 443-448
Author(s):  
Oluwaseyi Kayode Idowu ◽  
Oladimeji Ranti Babalola ◽  
Adesegun Tibramiyu Abudu
Keyword(s):  
Bone Growth ◽  
Proximal Tibia ◽  
Malignant Tumors ◽  
Lower Limbs ◽  
Skeletally Immature ◽  
Femoral Bone ◽  
Endoprosthetic Replacement ◽  
Femoral Length ◽  
The Mean

There is increasing preference for limb salvage techniques in the management of pediatric musculo- skeletal tumors. This study was aimed at evaluating femoral growth following proximal tibia resection (PTR) and placement of an extendible endoprosthesis with sliding stem. This was a retrospective study. The demographic and clinical data were collected. All the patients with malignant tumors were fully staged and commenced on appropriate chemotherapy. An expected discrepancy of > 3cm was considered sub- stantial enough to warrant extendible prosthesis. Twelve patients who had follow up full length scanogram of the lower limbs were included for the evaluation of femoral growth. The last available scanograms were used for growth comparison of the femur. The age at resection for all twelve patients ranged from 4-13 years. The commonest histological diagnosis was Osteosarcoma. In the twelve patients assessed for the growth of femur, the mean femoral length was 96% [89%-102%] of the unaffected femur. Distal femoral physeal growth continued after im- plantation of a sliding extendible prosthesis after resection of proximal tibia tumors.

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