Conference 2021 Pre-Recorded Video
Experience in the reconstruction of postoperative defects in sarcomas of the forearm bones in children. Analysis of clinical cases.
Authors and Affiliations
A. A. Zagidullina1, V. Kh. Harbediya2, A. Z. Dzampaev2, D. V. Nisichenko2, D. B. Khestanov2
1. International Faculty of the Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
2. Sugical Department №3 of the General Oncology of the Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO), Moscow, Russia
Osteosarcoma is an extremely malignant mesenchymal, highly differentiated tumor from bone tissue, proceeding aggressively, characterized by the rapid development of distant metastases.
In our study, we decided to check the possibility of complications, the level of restoration of functions according to the MSTS and TESS scales after endoprosthesis, and the installation of a spacer in 7 children aged 8 to 15 years, who received treatment at the Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation in the period 2013–2019. Osteosarcoma was diagnosed in 4 patients, and Ewing’s sarcoma in 3 patients. They underwent organ-preserving surgical treatment of the upper limb in one of three ways – endoprosthesis, placement of a spacer, and replacement with autologous bone on microvascular anastomoses. In the course of the study, a method was used to assess limb function according to the Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (МSTS) scales.
It was found that in the postoperative period in all patients, regardless of the applied method of organ-preserving surgery, the results varied within 1.4–1.5 on the TESS scale, and 91–95% on the MSTS scale. Postoperative complications in the form of post-traumatic neuropathy and dislocation were identified in 4 patients. Local recurrence was diagnosed in 2 patients. It should be noted that the condition of all patients is currently satisfactory, no lethal cases have been identified.
We believe that the results of this study are promising. However, it is necessary to conduct a longer period of observation of patients and evaluate their 5-year survival.