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目的探讨原位微波消融技术在侵及骨组织的软组织肿瘤保肢手术中的应用价值。方法对2009年3月-2011年8月收治的10例侵及骨组织的恶性或交界性软组织肿瘤患者结合原位微波消融技术进行保肢手术,术后3个月按骨与软组织肿瘤协会(Musculoskeletal Tumor Society,MSTS)评分评估术后肢体功能,观察随访期间局部复发及周身转移情况。结果 10例病例全部获得随访,平均随访时间8.9个月(3～25个月)。保肢手术全部成功,MSTS评分上肢1例27分,下肢9例平均25分(16～30分)。优良率为90%。术后3、17个月局部复发各1例,肺部转移2例。其中1例复发伴肺转移患者截肢术后3个月死亡,余2例末次随访时均带瘤生存。结论在严格掌握手术适应证的基础上对侵及骨组织的软组织肿瘤施行结合原位微波消融技术的保肢手术,可以在未增加复发率的情况下降低手术操作难度,提高成功率,初步临床效果满意。
Objective To investigate the value of in situ microwave ablation in limb salvage surgery of infiltrating bone tissue. Methods 10 cases of malignant or borderline soft tissue tumors with invasion of bone tissue from March 2009 to August 2011 were treated with limbal microwave ablation technique. According to the bone and soft tissue tumor association ( Musculoskeletal Tumor Society (MSTS) score to assess postoperative limb function and to observe the local recurrence and global metastasis during follow-up. Results All the 10 cases were followed up for a mean of 8.9 months (range 3 to 25 months). All limb salvage operations were successful. MSTS score was 27 cases in upper limbs and 9 cases in lower limbs with an average of 25 points (16-30 points). Excellent rate of 90%. There were 1 case of local recurrence 3 months and 2 cases of pulmonary metastasis 3 and 17 months after operation. One case of recurrent pulmonary metastasis died of amputation 3 months after surgery, the remaining 2 cases were alive at the last follow-up. Conclusion Strictly grasp the indications based on surgical indications of invasion of soft tissue tumors of the bones combined with in situ microwave ablation of limb salvage surgery can reduce the difficulty of operation without increasing the recurrence rate and improve the success rate of the initial clinical Satisfactory results.