Advertisement for orthosearch.org.uk
Results 1 - 3 of 3
Results per page:
Applied filters
Content I can access

Include Proceedings
Dates
Year From

Year To
Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 468 - 468
1 Jul 2010
Gafur-Akhunov M Abdikarimov K Islamov U Nasritdinov F Abdurasulov R
Full Access

The results of treatment of 45 patients with malignant bone tumors and soft tissues of thigh proximal part and pelvis have been analyzed in the work. From 45 male patients −37 (82%), women −8 (18%). Patients’ age varied from 17-to 53 years old, in average was-33 year old. In 22 patients the tumor localized in thigh proximal part, in 17 – in the bone and soft pelvic tissues, in 2- in the buttock part and in 4- noticed metastasis lesion inguinaliliac lymph nodes. In 5 observations histological type composed from malignant gigantic cellular tumor, in 8 osteogen sarcomas, in 11-hondro-sarcomas, in 5-Ewing’s sarcomas, in 4 – fibrosarcoma of soft tissues, in 4-rabdomiosarcomas, in 1- angiosar-coma of soft tissues, in 1-leiomyosarcomas, in 1-synovial sarcomas, in 1- polymorph cellular sarcomas of soft tissues and in 4- marked metastasis lesion (mainly flat cellular skin cancer) lymph nodes of inguinal-iliac part. The complex diagnostic measures including clinic, X-ray and ultrasound diagnostics, angiography, computed magnetic – resonance tomography and morphologic investigations were carried out with all patients.

A size of tumor process is 250–450cm3. In all cases carried out lymph dissection with removing of cellular tissue of pelvis till bifurcation of abdominal aorta, in 5 additionally are made sacrum resection. Duration of operational interference was from 150 to 189 minutes, and blood lost – from 1200 to 1800 ml. There were no mortality outcomes during the operation. The patients have been observed from 1 year till 12 years. During observation period from 45 patients in 4 (8%) have been determined local recurrence, in 12 (26%) – separated metastasis and in 2 (4%) –simultaneously determined recurring and separated metastasis. Findings of 3 and 5 years survival are 44,6% and 33,5%.

So, interpelvic-abdominal amputation prolongs patients’ surveillance, which before is considered hopeless and mainly undergone palliative chemotherapy and symptomatic treatment.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 471 - 471
1 Jul 2010
Urunbayev S Gafur - Akhunov MA Abdikarimov K Karahojaev B Davletov R
Full Access

In 36 patients was carried out short-lived hyperglycemia and local hyperthermic prolonged intraarterial chemotherapy on the background of modificators of short-lived hyperglycemia in the department of general oncology of R. O.S. C of the H.M of the Republic of Uzbekistan. Tumour has localized in distal part of femoral bones in 18 patients, in proximal part of cannon bones in 13. Treatment was carried out by the scheme of Syclophosphan 1000 mg/m2 doxorubicin 90 mg/ m2 48-hourly unbroken infusion, cycplatin 100 mg2 in the dependence from efficacy of the treatment has been carried out from 1 to 4 courses In 3–4 hours time after beginning prolonged intraarterial chemotherapy unbrokenly began short-lived hyperglycemia by the way of introduction i/v solution of glucose 20% to1500ml. Maximal concentration of the blood sugar level has composed 18–23ml in the period of treatment. Then local hyperthermia with USD apparatus was carried out in 30MG frequency regime with exposition of 20 min. time. Control group of the patients has composed patients, who has performed system chemotherapy by analogical scheme CAP (in 34 patients). In the patients group, who received prolonged intraarterial chemotherapy with modificators (short-lived hyperglycemia with local hyperthermia) in 4 (11, 1%) patients have been observed full effect, in 25 patients (69, 4%) partial effect, in 5 (13,9%) stabilization, and in 2 (5,6%) progressing of tumour process. Safe operation was performed in 17 patients (47, 2%), crippling in 4 (11,4%) patients, conservative treatment in 15 patients (41,6%) in this group. In patients, who was carried out system chemotherapy full effect was marked in 2 (5,9%) patients, partial effect in 8 (23,5%), stabilization in 15 (44,1%) and progressing in 9 (26,5%) patients. Safe operations were carried out in 3 (8,8%), crippling operations in 19 (55,9%), other 12 (35,3%) patients are under observation after conducting 9 courses of chemotherapy and beam therapy without operation in conservative treatment.

Endovascular chemotherapy in combination with local hyperthermia and short – lived hyperglycemia allows overcoming medicinal steadiness and increases quantity of safe operations. That’s why combination prolonged intraarterial chemotherapy with modifications is aimed.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 468 - 468
1 Jul 2010
Abdikarimov K Gafur-Ahunov M Islamov U Nasritdinov F Iskandarov K Karahojaev B
Full Access

We observed the 55 patients with local spread tumours of bones and soft tissues of shoulder girdle. There were 43 (78,2%) men, 12 (21,8%) women; the average age was 38,8. In 23 patients the tumour became localized into proximal part of humerus, 2 were in lateral end of clavicle, 4 were in shoulder blade, 18 were in soft tissues of upper two thirds of shoulder, 4 were in soft tissues of axiila, 3 were in soft tissues of shoulder blade and 1 was metastases of sarcoma of forearm soft tissues in armpit lymph nodes. In 8 cases the bone tumours were presented with osteosarcoma, 12 – hondrosarcoma, 5 – malignant giant celled tumour, 1 – Ewing’s sarcoma, 1 – reticulosarcoma, 2 – fibrosarcoma of bone. Among tumours of soft tissues, the fibrosarcoma and synovial sarcoma prevailed over 10 and 8.

Regard for local spread of tumour and degree of anatomical structures drawing in process, 47 patients performed interscapulothoracic amputation and 8 were interscapulothoracic resection (Tikhoff-Linberg operation). In pre- and post operative period the chemical and/or radiotherapy were performed in 43 patients. Selection the scheme and regimen of treatment depended on histological type of tumour.

The dates of observation were from 6 month to 14 years. The acute disorder of cerebral blood circulation was developed in one patient after interscapulothoracic amputation in early postoperative period. The local recurrence of tumour was revealed in 4 patients (8,4%) after interscapulothoracic amputation and in 3 patients (37,5%) after interscapulothoracic resection, in 14 (29,7%) and 4 (50%) were metastases conditionally. All patients had local recurrence in soft tissues. In 2 patients with local recurrence the amputation of extremities were performed.

There fore, the interscapulothoracic resection is used in local spread tumours of proximal part of humerus, shoulder blade, acromical part of clavicle and soft tissues of shoulder girdle, with some anatomical structures involved in process, but without affection of vascular-nerve fascicules. Involving in tumor process vascular and nerve plexus are statement for performing interscapulothoracic amputation.