Reendovascular occlusion of pathologic vessels responsible for the blood supply of highly vascularized tumors of the femur, large pelvic bones, spine and tumor-like foci was used in 20 patients. High efficacy of the method was demonstrated. Marked reduction of the pathologic blood flow resulted in the decreased blood loss during organ saving operations for malignant tumors. Improvement of bone tissue structure in aneurismal cyst and pelvic bones hemangioma was accompanied by manifest positive clinical dynamics. At palliative treatment of patients with inoperable and metastatic tumors rapid and significant reduction of pain syndrome was noted.
The evaluation of the CT efficacy for the elaboration and realization of low invasive diagnosis and treatment in bone pathology was performed. Sixty two patients, aged from 6 to 80, were examined. The method of stereotaxic determination of pathologic locus localization with CT controlled manipulation (target biopsy, anchor navigation in disorder focus, injection of contrast matter and introduction of plastic materials into the focus) was used. The efficacy of those method made up 89.6% for target biopsy corresponding to the high degree accuracy of pathological process identification and 100%) for the preoperative marking. New elaborated method is accurate and safe for the patients.
Long-term outcomes of reconstructive operations for substitution of post-resection defects of the articular ends of tubular bones that form the hip, knee and shoulder joints using home endoprosthesis were studied. The study included 344 patients who were treated at CITO department of bone pathology from 2004 to 2014. Substitution of the defect was performed in 236 and 108 cases for the knee, hip joints, respectively. Indications for surgical intervention were: bone tumors; previously performed arthroplasty failure; defects of the articular ends after failed traumatologic and orthopaedic operations; severe forms of knee arthroses. Functional results (MSTS scale), survival of constructions, inflammatory complications were analyzed and comparative evaluation with imported analogues was performed. General functional outcomes and rate of complications correspond to the data on application of new oncologic and modular endoprostheses presented in foreign literature.
Oncologic and orthopaedics results of surgical treatment of 32 patients with benign tumors of the thoracic and lumbar spine were analyzed. Tumors were manifested by the following nosologic forms: hemangioma, giant cell tumor, osteoid osteoma, osteoblastoma. Follow up period was from 2 to 16 years, at the time of results evaluation all patients were alive. It was shown that the following factors were responsible for the impairment of treatment results: late diagnosis, surgical treatment at nonspecialized clinics, widely spread tumor, severe neurologic disorders, spine deformity in the postoperative period.
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