PREVENTION AND CONTROL STRATEGIES OF COMMON POST-OPERATIVE COMPLICATIONS OF MICROWAVE ABLATION IN SITU IN TREATMENT OF BONE TUMORS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Xiaoming , ZHANG Yu , ZHANG Tao , XU Liang , KE Jin , MA Limin , LAN Guobo , YAO Zilong , OUYANG Lanfei , HUANG Huayang , XIA Hong , YIN Qingshui.

Department of Bone Disease and Joint, Hospital of Orthopedics, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou Guangdong, 510010, P.R.China. Corresponding author: ZHANG Yu, E-mail: luck_2001@126.com;

Corresponding author：

Keywords：

原位微波消融术; 骨肿瘤; 并发症

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Objective To analyze the common post-operative complications of microwave ablation in situ in the treatment of bone tumors and the prevention and control strategies. Methods Between March 2009 and July 2012, 73 cases of bone tumors were treated with microwave ablation in situ, of which 54 cases met the inclusion criteria. There were 31 males and 23 females with a median age of 27 years (range, 9-74 years), including 37 malignant tumors and 17 benign tumors. In 49 primary bone tumors, 17 cases were in stage 3, 13 in stage IIA, and 19 in stage IIB according to Enneking grading system. The postoperative complications, managements, and outcomes in patients were analyzed. Results After operation, 54 patients were followed up 12-40 months (mean, 24 months). Seven kinds of complications occurred in 21 patients (38.9%) with 3 cases suffered from more than one, including pathologic fracture in 4 cases (7.4%), deep infection in 2 cases (3.7%), nerve injury in 7 cases (13.0%), deep vein thrombosis of the lower extremity in 1 case (1.9%), medial collateral ligament heat injury of the knee in 1 case (1.9%), hematoma in 2 cases (3.7%), and fat liquefaction of incision and flap necrosis in 8 cases (14.8%). Conclusion Pathologic fracture is the primary complication which results in a second surgery. Deep infection is the main complication that often leads to failure of the limb salvage. Nerve injury and poor wound healing are the most common complications. Good control of microwave temperature is the key to successful operation, and the related preventive strategies could reduce complications.

Citation： YANG Xiaoming,ZHANG Yu,ZHANG Tao,XU Liang,KE Jin,MA Limin,LAN Guobo,YAO Zilong,OUYANG Lanfei,HUANG Huayang,XIA Hong,YIN Qingshui.. PREVENTION AND CONTROL STRATEGIES OF COMMON POST-OPERATIVE COMPLICATIONS OF MICROWAVE ABLATION IN SITU IN TREATMENT OF BONE TUMORS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(12): 1473-1476. doi: Copy

1.	Shibata T, Takami M, Fujimoto T, et al. Microwave tumor coagulation (MTC) in liver tumor: indication and percutaneous approach. Gan To Kagaku Ryoho, 1994, 21(13): 2128-2131.
2.	Moriyama E, Matsumi N, Shiraishi T, et al. Fundamental study of differential hypothermia treatment of brain tumor using an interstitial microwave antenna. No Shinkei Geka, 1987, 15(12): 1291-1297.
3.	Gillams A. Tumour ablation: current role in the liver, kidney, lung and bone. Cancer Imaging, 2008, 8 Speci No A: S1-5.
4.	Fan QY, Ma BA, Zhou Y, et al. Bone tumors of the extremities or pelvis treated by microwave-induced hyperthermia. Clin Orthop Relat Res, 2003, (406): 165-175.
5.	Fan QY, Ma BA, Qlu XC, et al. Preliminary report on treatment of bone tumors with microwave-induced hyperthermia. Bioelectromagnetics, 1996, 17(3): 218-222.
6.	Fan Q, Ma B, Guo A, et al. Surgical treatment of bone tumors in conjunction with microwave-induced hyperthermia and adjuvant immunotherapy. A preliminary report. Chin Med J (Engl), 1996, 109(6): 425-431.
7.	刘自立, 尚希福, 胡飞, 等. 微波治疗骨肿瘤的原理及临床应用研究进展. 中国骨肿瘤骨病, 2011, 10(1): 78-81.
8.	叶军, 徐可为, 蔡和平, 等. 微波高温处理的人皮质骨生物力学性质的研究. 中国生物医学工程学报, 2004, 23(1): 15-20.
9.	胡永成, 王继芳, 卢世璧, 等. 微波加热对骨组织生物力学的影响. 中华骨科杂志, 1997, 17(10): 645-648.
10.	赵廷宝, 范清宇, 张殿忠, 等. 骨形成蛋白-脱钙骨基质颗粒-骨水泥复合材料修复狗股骨微波灭活骨缺损后的长期观察. 中国矫形外科杂志, 2004, 12(17): 1320-1322.
11.	周勇, 范清宇, 蒋维中, 等. 异体脱钙骨基质骨粒骨水泥骨形态发生蛋白复合材料的成骨诱导活性. 第四军医大学学报, 1999, 20(12): 1085-1087.
12.	胡运生, 范清宇, 周勇, 等. 异体脱钙骨基质明胶骨粒/骨水泥复合材料的生物力学性能研究. 中国修复重建外科杂志, 2002, 16(2): 97-99.
13.	范清宇, 马保安, 周勇, 等. 肢体恶性骨肿瘤的微波高温原位灭活保肢术. 中国矫形外科杂志, 2009, 17(11): 801-806.
14.	范清宇, 马保安, 周勇, 等. 插入式微波天线阵列诱导高温原位灭活治疗肢体恶性或侵袭性骨肿瘤. 第四军医大学学报, 1999, 20(12): 1024-1028.
15.	刘振东, 范清宇, 马保安, 等. 成年狗股骨微波高温灭活后的再血管化研究. 中华骨科杂志, 1998, 18(11): 682-685.
16.	姜鹏翔, 李建民. 恶性骨肿瘤保肢手术并发症的原因及防治. 临床骨科杂志, 2005, 8(2): 116-120.
17.	胡永成, 卢世璧, 王继芳, 等. 恶性骨肿瘤微波原位热疗保留肢体的手术技术. 中华骨科杂志, 2000, 20(7): 410-415.
18.	Malawer MM, Chou LB. Prosthetic survival and clinical results with use of large-segment replacements in the treatment of high-grade bone sarcomas. J Bone Joint Surg (Am), 1995, 77(8): 1154-1165.
19.	于秀淳, 刘晓平, 周银, 等. 腓肠肌内侧头肌瓣在胫骨上端恶性骨肿瘤保肢术中的应用. 中国现代医学杂志, 2003, 13(16): 128-131.
20.	Jeon DG, Kawai A, Boland P, et al. Algorithm for the surgical treatment of malignant lesions of the proximal tibia. Clin Orthop Relat Res, 1999, (358): 15-26.
21.	Brace CL. Microwave tissue ablation: biophysics, technology, and applications. Crit Rev Biomed Eng, 2010, 38(1): 65-78.

1. Shibata T, Takami M, Fujimoto T, et al. Microwave tumor coagulation (MTC) in liver tumor: indication and percutaneous approach. Gan To Kagaku Ryoho, 1994, 21(13): 2128-2131.
2. Moriyama E, Matsumi N, Shiraishi T, et al. Fundamental study of differential hypothermia treatment of brain tumor using an interstitial microwave antenna. No Shinkei Geka, 1987, 15(12): 1291-1297.
3. Gillams A. Tumour ablation: current role in the liver, kidney, lung and bone. Cancer Imaging, 2008, 8 Speci No A: S1-5.
4. Fan QY, Ma BA, Zhou Y, et al. Bone tumors of the extremities or pelvis treated by microwave-induced hyperthermia. Clin Orthop Relat Res, 2003, (406): 165-175.
5. Fan QY, Ma BA, Qlu XC, et al. Preliminary report on treatment of bone tumors with microwave-induced hyperthermia. Bioelectromagnetics, 1996, 17(3): 218-222.
6. Fan Q, Ma B, Guo A, et al. Surgical treatment of bone tumors in conjunction with microwave-induced hyperthermia and adjuvant immunotherapy. A preliminary report. Chin Med J (Engl), 1996, 109(6): 425-431.
7. 刘自立, 尚希福, 胡飞, 等. 微波治疗骨肿瘤的原理及临床应用研究进展. 中国骨肿瘤骨病, 2011, 10(1): 78-81.
8. 叶军, 徐可为, 蔡和平, 等. 微波高温处理的人皮质骨生物力学性质的研究. 中国生物医学工程学报, 2004, 23(1): 15-20.
9. 胡永成, 王继芳, 卢世璧, 等. 微波加热对骨组织生物力学的影响. 中华骨科杂志, 1997, 17(10): 645-648.
10. 赵廷宝, 范清宇, 张殿忠, 等. 骨形成蛋白-脱钙骨基质颗粒-骨水泥复合材料修复狗股骨微波灭活骨缺损后的长期观察. 中国矫形外科杂志, 2004, 12(17): 1320-1322.
11. 周勇, 范清宇, 蒋维中, 等. 异体脱钙骨基质骨粒骨水泥骨形态发生蛋白复合材料的成骨诱导活性. 第四军医大学学报, 1999, 20(12): 1085-1087.
12. 胡运生, 范清宇, 周勇, 等. 异体脱钙骨基质明胶骨粒/骨水泥复合材料的生物力学性能研究. 中国修复重建外科杂志, 2002, 16(2): 97-99.
13. 范清宇, 马保安, 周勇, 等. 肢体恶性骨肿瘤的微波高温原位灭活保肢术. 中国矫形外科杂志, 2009, 17(11): 801-806.
14. 范清宇, 马保安, 周勇, 等. 插入式微波天线阵列诱导高温原位灭活治疗肢体恶性或侵袭性骨肿瘤. 第四军医大学学报, 1999, 20(12): 1024-1028.
15. 刘振东, 范清宇, 马保安, 等. 成年狗股骨微波高温灭活后的再血管化研究. 中华骨科杂志, 1998, 18(11): 682-685.
16. 姜鹏翔, 李建民. 恶性骨肿瘤保肢手术并发症的原因及防治. 临床骨科杂志, 2005, 8(2): 116-120.
17. 胡永成, 卢世璧, 王继芳, 等. 恶性骨肿瘤微波原位热疗保留肢体的手术技术. 中华骨科杂志, 2000, 20(7): 410-415.
18. Malawer MM, Chou LB. Prosthetic survival and clinical results with use of large-segment replacements in the treatment of high-grade bone sarcomas. J Bone Joint Surg (Am), 1995, 77(8): 1154-1165.
19. 于秀淳, 刘晓平, 周银, 等. 腓肠肌内侧头肌瓣在胫骨上端恶性骨肿瘤保肢术中的应用. 中国现代医学杂志, 2003, 13(16): 128-131.
20. Jeon DG, Kawai A, Boland P, et al. Algorithm for the surgical treatment of malignant lesions of the proximal tibia. Clin Orthop Relat Res, 1999, (358): 15-26.
21. Brace CL. Microwave tissue ablation: biophysics, technology, and applications. Crit Rev Biomed Eng, 2010, 38(1): 65-78.

Chinese Journal of Reparative and Reconstructive Surgery

PREVENTION AND CONTROL STRATEGIES OF COMMON POST-OPERATIVE COMPLICATIONS OF MICROWAVE ABLATION IN SITU IN TREATMENT OF BONE TUMORS

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