Adjuvan tedavilerin anevrizmal kemik kistinde nüks üzerindeki etkileri

Yıl 2014, Cilt: 48 Sayı: 5, 500 - 506, 12.11.2014

Burcin Kececi Levent Kucuk Alovsat Isayev Dundar Sabah

https://doi.org/10.3944/AOTT.2014.14.0020

Öz

Bu çalışmadaki amacımız anevrizmal kemik kistinin tedavisinde uygulanan cerrahi tedavi yöntemi, yaş ve boşluk doldurma materyali gibi faktörlerin lokal nüks üzerine etkilerinin saptanması idi.

Çalışma planı: Çalışmamıza primer anevrizmal kemik kisti tanısı almış ve cerrahi olarak tedavi edilmiş, yaş ortalaması 17.9 olan 85 hasta dahil edildi. Hastaların 9’una eksizyon, 76’sına intralezyonel küretaj uygulandı. İntralezyonel küretaj grubundaki hastalar uygulanan adjuvan tedaviye göre 3 alt gruba ayrıldı. İlk gruba ek bir adjuvan tedavi görmezken; 2. gruba, ek olarak, yüksek devirli burr; 3. gruba, ek olarak, yüksek devirli burr ve alkol/fenol adjuvan tedavileri uygulandı. Kavitenin doldurulmasında kemik grefti ve kemik çimentosu kullanıldı. Hastaların ortalama takip süresi 107.5 ay idi. Gruplar lokal nüks oluşumu açısından incelenmiştir. On ve 20 yaş sınırlarının altında kist oluşumu negatif prognostik faktör kabul edildi ve istatistiksel analizi yapıldı.

Bulgular: Hastalarımızın 10’unda (%11.8) lokal nüks saptandı. Lokal nüksün ilk girişim sonrası ortaya çıkma süresi ortalama 10 ay idi. Uygulanan cerrahi tipleri, adjuvan tedavi grupları, yaş ve dolgu materyallerinin prognoz üzerine etkileri istatistiksel olarak anlamsız bulundu.

Çıkarımlar: Anevrizmal kemik kistinin intralezyonel tedavisinde en önemli aşama hala tüm kist duvarının özenli bir şekilde kürete edilmesi olarak gözükmektedir.

Anahtar Kelimeler

Biyopsi; kemik kisti; kemik tümörleri; küretaj.

Effect of adjuvant therapies on recurrence in aneurysmal bone cysts

Öz

Objective: The aim of this study was to define the effective factors such as surgical method, age and cavity filling materials on local recurrence in the treatment of aneurysmal bone cysts.

Methods: The study included 85 patients (mean age: 17.9 years) that received surgical treatment for primary aneurysmal bone cyst. Nine were treated with cyst excision and 76 with intralesional curettage. The intralesional curettage group was divided into 3 subgroups according to adjuvant therapies applied; the first group received no additional adjuvant therapy, the second group received additional high-speed burr and the third group received additional high-speed burr and alcohol/phenol adjuvant treatments. Bone graft or bone cement was used to fill in the cavity. Mean follow-up period was 107.5 months. Groups were analyzed statistically in terms of local recurrence. Onset of cyst in ages under 10 and 20 years were considered a negative prognostic factor and analyzed statistically.

Results: Local recurrence occurred in 10 (11.8%) patients. Mean duration between the initial operation and recurrence was 10 months. There was no significant difference in terms of local recurrence among the surgical treatment groups, adjuvant therapy groups, age groups and bone graft and bone cement groups.

Conclusion: Careful curettage of the entire cyst wall remains the most important step in the intralesional treatment of aneurysmal bone cyst.

Anahtar Kelimeler

Biopsy, bone cyst, bone neoplasms, curettage

Kaynakça

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