颅内外、颅内外定位原发性恶性肿瘤颅骨组织缺损闭合重建手术的改进

T. Morozov, M. Kvasha
{"title":"颅内外、颅内外定位原发性恶性肿瘤颅骨组织缺损闭合重建手术的改进","authors":"T. Morozov, M. Kvasha","doi":"10.26683/2786-4855-2023-1(43)-17-27","DOIUrl":null,"url":null,"abstract":"Objective ‒ to improve reconstructive and plastic methods of treatment of patients with malignant tumors that spread beyond the brain skull to ensure a decent quality of life.Materials and methods. The results of a comprehensive clinical examination and surgical treatment (with a reconstructive component) of 21 patients with scalp and skull tissue defects operated on in the extracerebral tumor clinic of Romodanov Institute of Neurosurgery of NAMS of Ukraine in the period from 2018 to 2021. There were 9 women and 12 men among the patients. The age of the patients is from 36 to 80 years old. All patients underwent clinical, neurological and instrumental examinations. The diagnosis was verified by the results of histopathomorphological examination. Statistical methods (discriminant analysis (MANOVA)) were used for data processing. Statistical significance was tested using the Pearson test (χ²).Results. The patients were divided into two groups. The main group (n=16) – operated on using adapted patented plastic techniques that take into account the optimal angle of direction of stress vectors in the tissue of skin-aponeurotic flaps in the postoperative period during stress relaxation. The comparison group was made up of 5 people operated on using traditional methods of mobilization and fixation of skin-aponeurotic flaps. Using the patient’s own tissues is the most reliable and effective method of cosmetic restoration of the head after radical treatment for locally advanced tumors. Active tactics (postoperative monitoring of the flap) make it possible to detect blood circulation disorders in the transplanted tissues at an early stage and to carry out a timely revision of the anastomoses. Performing simultaneous reconstructive operations is an integral part of complex treatment of patients with malignant tumors, expands the indications for performing gentle operations, allows to obtain «excellent» and «good» functional and aesthetic results in 85 % of cases. Simultaneous microsurgical reconstructive operations are possible in patients after complex treatment, although the frequency of thrombotic complications in this group was higher (12.5 %) than in the comparison group (7.5 %).Conclusions. The perspective of plastic-reconstructive replacement of defects for clinical application has been proven and the method has been improved using the latest technologies.Key words: malignant tumors; intracranial/extracranial spread; surgical treatment; reconstruction; quality of life.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improvement of reconstructive surgical operations with closure of skull tissue defects in primary malignant tumors with intra-extracranial and extra-intracranial localization\",\"authors\":\"T. Morozov, M. Kvasha\",\"doi\":\"10.26683/2786-4855-2023-1(43)-17-27\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective ‒ to improve reconstructive and plastic methods of treatment of patients with malignant tumors that spread beyond the brain skull to ensure a decent quality of life.Materials and methods. The results of a comprehensive clinical examination and surgical treatment (with a reconstructive component) of 21 patients with scalp and skull tissue defects operated on in the extracerebral tumor clinic of Romodanov Institute of Neurosurgery of NAMS of Ukraine in the period from 2018 to 2021. There were 9 women and 12 men among the patients. The age of the patients is from 36 to 80 years old. All patients underwent clinical, neurological and instrumental examinations. The diagnosis was verified by the results of histopathomorphological examination. Statistical methods (discriminant analysis (MANOVA)) were used for data processing. Statistical significance was tested using the Pearson test (χ²).Results. The patients were divided into two groups. The main group (n=16) – operated on using adapted patented plastic techniques that take into account the optimal angle of direction of stress vectors in the tissue of skin-aponeurotic flaps in the postoperative period during stress relaxation. The comparison group was made up of 5 people operated on using traditional methods of mobilization and fixation of skin-aponeurotic flaps. Using the patient’s own tissues is the most reliable and effective method of cosmetic restoration of the head after radical treatment for locally advanced tumors. Active tactics (postoperative monitoring of the flap) make it possible to detect blood circulation disorders in the transplanted tissues at an early stage and to carry out a timely revision of the anastomoses. Performing simultaneous reconstructive operations is an integral part of complex treatment of patients with malignant tumors, expands the indications for performing gentle operations, allows to obtain «excellent» and «good» functional and aesthetic results in 85 % of cases. Simultaneous microsurgical reconstructive operations are possible in patients after complex treatment, although the frequency of thrombotic complications in this group was higher (12.5 %) than in the comparison group (7.5 %).Conclusions. The perspective of plastic-reconstructive replacement of defects for clinical application has been proven and the method has been improved using the latest technologies.Key words: malignant tumors; intracranial/extracranial spread; surgical treatment; reconstruction; quality of life.\",\"PeriodicalId\":325397,\"journal\":{\"name\":\"Ukrainian Interventional Neuroradiology and Surgery\",\"volume\":\"41 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-02-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ukrainian Interventional Neuroradiology and Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.26683/2786-4855-2023-1(43)-17-27\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ukrainian Interventional Neuroradiology and Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.26683/2786-4855-2023-1(43)-17-27","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

目的:改进恶性肿瘤扩散至颅脑外的重建和整形治疗方法,确保患者的生活质量。材料和方法。对2018年至2021年在乌克兰NAMS罗莫达诺夫神经外科研究所脑外肿瘤门诊手术的21例头皮和颅骨组织缺损患者进行综合临床检查和手术治疗(含重建成分)的结果。患者中女性9例,男性12例。患者年龄36 ~ 80岁。所有患者均接受了临床、神经学和仪器检查。组织病理检查结果证实了诊断。采用统计方法(判别分析(MANOVA))进行数据处理。采用Pearson检验(χ 2)进行统计学显著性检验。患者被分为两组。主要组(n=16)采用适应的专利整形技术进行手术,该技术考虑了应力松弛期间皮肤腱膜瓣组织中应力矢量的最佳方向角。对照组5例,采用传统的皮肤腱膜皮瓣的游离固定方法。局部晚期肿瘤根治后,利用患者自身组织进行头部美容修复是最可靠、最有效的方法。主动策略(术后皮瓣监测)可以早期发现移植组织的血液循环障碍,及时对吻合口进行翻修。同时进行重建手术是恶性肿瘤患者复杂治疗中不可分割的一部分,扩大了进行温和手术的适应症,使85%的病例获得“优秀”和“良好”的功能和美学结果。经过复杂治疗的患者可以同时进行显微外科重建手术,尽管该组血栓性并发症的发生率(12.5%)高于对照组(7.5%)。应用最新的技术对缺损的修复方法进行了改进,并证实了缺损的塑性重建置换的临床应用前景。关键词:恶性肿瘤;颅内或颅外扩散;外科治疗;重建;生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improvement of reconstructive surgical operations with closure of skull tissue defects in primary malignant tumors with intra-extracranial and extra-intracranial localization
Objective ‒ to improve reconstructive and plastic methods of treatment of patients with malignant tumors that spread beyond the brain skull to ensure a decent quality of life.Materials and methods. The results of a comprehensive clinical examination and surgical treatment (with a reconstructive component) of 21 patients with scalp and skull tissue defects operated on in the extracerebral tumor clinic of Romodanov Institute of Neurosurgery of NAMS of Ukraine in the period from 2018 to 2021. There were 9 women and 12 men among the patients. The age of the patients is from 36 to 80 years old. All patients underwent clinical, neurological and instrumental examinations. The diagnosis was verified by the results of histopathomorphological examination. Statistical methods (discriminant analysis (MANOVA)) were used for data processing. Statistical significance was tested using the Pearson test (χ²).Results. The patients were divided into two groups. The main group (n=16) – operated on using adapted patented plastic techniques that take into account the optimal angle of direction of stress vectors in the tissue of skin-aponeurotic flaps in the postoperative period during stress relaxation. The comparison group was made up of 5 people operated on using traditional methods of mobilization and fixation of skin-aponeurotic flaps. Using the patient’s own tissues is the most reliable and effective method of cosmetic restoration of the head after radical treatment for locally advanced tumors. Active tactics (postoperative monitoring of the flap) make it possible to detect blood circulation disorders in the transplanted tissues at an early stage and to carry out a timely revision of the anastomoses. Performing simultaneous reconstructive operations is an integral part of complex treatment of patients with malignant tumors, expands the indications for performing gentle operations, allows to obtain «excellent» and «good» functional and aesthetic results in 85 % of cases. Simultaneous microsurgical reconstructive operations are possible in patients after complex treatment, although the frequency of thrombotic complications in this group was higher (12.5 %) than in the comparison group (7.5 %).Conclusions. The perspective of plastic-reconstructive replacement of defects for clinical application has been proven and the method has been improved using the latest technologies.Key words: malignant tumors; intracranial/extracranial spread; surgical treatment; reconstruction; quality of life.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信