Postoperative complications with cryotherapy in bone tumors
| Autor: | Earl Brien, Katie Vincent, Clark J. Chen, John M. Garlich |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Cryoablation
medicine.medical_specialty lcsh:Diseases of the musculoskeletal system medicine.medical_treatment Cryotherapy Review Article Bone grafting lcsh:RC254-282 Cryosurgery Curettage 03 medical and health sciences 0302 clinical medicine medicine Adjuvant therapy 030222 orthopedics business.industry Soft tissue Benign aggressive bone tumor medicine.disease Liquid nitrogen lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Surgery Oncology 030220 oncology & carcinogenesis Soft tissue injury Radiology lcsh:RC925-935 business Complication |
| Zdroj: | Journal of Bone Oncology, Vol 7, Iss C, Pp 13-17 (2017) Journal of Bone Oncology |
| ISSN: | 2212-1374 |
| Popis: | The technique of cryosurgery has been used to control local recurrence in a variety of benign and malignant bone tumors. Early studies revealed significant complication rates (25%) that included fracture, infection, and soft tissue injury. Our method of cryosurgery has yielded excellent tumor control with improved complication rates. The objective of this study is to determine the characteristics of postoperative complications after pouring liquid nitrogen into curettaged bone defects, and to review our current indications and surgical technique in bone tumor management. We reviewed charts in over 200 patients who received cryoablation for bone tumors from 1994 to 2015. Imaging studies were evaluated in all patients diagnosed with a complication. All patients receiving cryotherapy had soft tissue management intraoperatively that included warm saline directed to the structures. Liquid nitrogen was poured into the bone defect and in some cases, additional spraying with a cryogun into the defect was performed. The majority of cryotherapy was used in cases of active or aggressive benign tumors. Our low complication rate of 2.34% included 1 post-operative fracture, 3 infection, and 1 paraesthesia. Bone graft or cementation was used in the majority of patients, all of which fully incorporated. Cryoablation is an excellent from of adjuvant therapy for active and aggressive benign tumors and may be used in malignant tumors as well. Soft tissue protection is critical to avoid skin necrosis and wound breakdown. We recommend the use of cryotherapy in active and aggressive bone tumors as an adjuvant treatment prior to bone grafting or cementation. Highlights • Cryoablation as an adjuvant treatment is recommended in active and aggressive benign tumors. • A combination of a slow freeze and quick thaw, repeated for two cycles giving optimal penetration and stability across structures. • Soft tissue management with warm saline is critical in preventing intraoperative injury. • Controlled cryotherapy techniques can limit complication rates and local recurrence rates. |
| Databáze: | OpenAIRE |
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