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題名 | Treatment of Giant Cell Tumor of Bone:A Comparison of Local Curettage and Wide Resection=以刮除和廣泛切除來治療骨巨細胞瘤之比較 |
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作者 | 劉華山; 王俊聞; | 書刊名 | 長庚醫學 |
卷期 | 21:1 1998.03[民87.03] |
頁次 | 頁37-43 |
分類號 | 416.66 |
關鍵詞 | 骨巨細胞瘤; 刮除術; 廣泛切除術; Giant cell tumor of bone; Curettage; Wide resection; |
語文 | 英文(English) |
中文摘要 | 背景:骨巨細胞瘤是一個良性的腫瘤,但是它具有局部復發的特性。雖然治療的 方法有很多種,但對於一個骨科醫師來說,治療骨巨細胞瘤仍是一個棘手的問題。 方法:自1981年7月至1995年1月,共有27例良性骨巨細胞瘤接受手術治療。其中11例採用 刮除術加上輔助療法和骨泥填塞來治療,另外16例是採用廣泛切除來治療。 結果:術後追蹤平均50個月,11例採用刮除術加上輔助療法和骨泥填塞的患者,有3例發生 局部復發。其中2例接受同樣的治療後而痊癒。16例接受廣泛切除術來治療的患者,只有 1例發生局部復發,但有3例術發生感染。 結論:二種手術方法都能有效地控制腫瘤的再發。但是採用刮除術加上輔助療法和骨泥填 塞更能使患者在肢體功能上達到滿意的結果,同時也能減少手術的後遺症,即使腫瘤再發 ,也可經由放射學檢查提早發現,並且可重覆採用刮除術,也可採用廣泛切除術來治療。 |
英文摘要 | Background: Giant cell tumor of bone is a benign but locally aggressive neoplasm with a tendency for local recurrence. Although various treatment options have been utilized and reported, it remains a difficult therapeutic problem for the orthopedic surgeon. Methods: We reviewed the results of the treatment of giant cell tumor of bone in 27 patients. Eleven patients were treated with extended curettage and burring then packing with cement, while 16 patients had wide resection and reconstruction. Results: At an average of 50 months after surgery, the recurrence rate of curettage was 27% and that of wide resection was 6.25%. Two of the three patients who had a recurrence after curettage were treated by a secondary curettage procedure and were later free of disease. Overall, the local control rate after second curettage and packing with cement was 90.9%. There ".as no infection in the curettage group but infection occurred in 3 patients of the resection group. Eight patients in the curettage group ( 80%) had an excellent functional result but only 2 patients in the resection group (13%) achieved an excellent result. Conclusion: This study demonstrates that either curettage and packing with cement or wide resection are effective in treatment of giant cell tumor of bone. There is, however, a better functional result after curettage and packing with cement than following wide resection. We recommend curettage and cement packing for giant cell tumor of bone whenever it is technically feasible. |
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