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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
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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 468 - 468
1 Jul 2010
Abdikarimov K Gafur-Ahunov M Islamov U Nasritdinov F Iskandarov K Karahojaev B
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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.