{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T18:45:49Z","timestamp":1648838749099},"reference-count":0,"publisher":"Akademiai Kiado Zrt.","issue":"45","license":[{"start":{"date-parts":[[2020,11,8]],"date-time":"2020-11-08T00:00:00Z","timestamp":1604793600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2020,11,8]]},"abstract":"<jats:p><jats:bold>\u00d6sszefoglal\u00f3.<\/jats:bold>  A malignus csonttumorok seb\u00e9szi ell\u00e1t\u00e1sa sor\u00e1n\n                    kialakul\u00f3 szegment\u00e1lis csontdefektusok p\u00f3tl\u00e1sa fontos szempont a v\u00e9gtagmegtart\u00f3\n                    seb\u00e9szetben. Feln\u0151ttkorban a megold\u00e1s rendszerint tumorprot\u00e9zis be\u00fcltet\u00e9se, 10\n                    \u00e9vesn\u00e9l fiatalabb gyermekekn\u00e9l azonban ez nehezen alkalmazhat\u00f3 m\u00f3dszer a kis\n                    csontm\u00e9ret \u00e9s az igen magas v\u00e1rhat\u00f3 sz\u00f6v\u0151dm\u00e9nyar\u00e1ny miatt. A bemutatott,\n                    haz\u00e1nkban m\u00e9g ritk\u00e1n alkalmazott beavatkoz\u00e1s, a tumoros csontszegmentum m\u0171t\u00e9t\n                    alatti sug\u00e1rkezel\u00e9se, vissza\u00fcltet\u00e9se megfelel\u0151 rekonstrukci\u00f3s lehet\u0151s\u00e9g a v\u00e9gtag\n                    funkci\u00f3j\u00e1nak megtart\u00e1sa mellett, cs\u00f6kkentve a k\u00e9s\u0151bbi reoper\u00e1ci\u00f3k,\n                    prot\u00e9zisrev\u00edzi\u00f3k sz\u00e1m\u00e1t. <jats:italic>C\u00e9lkit\u0171z\u00e9s:<\/jats:italic> A haz\u00e1nkban eddig az\n                    ismertetett m\u00f3don v\u00e9gzett m\u0171t\u00e9tek bemutat\u00e1sa, az eredm\u00e9nyek \u00f6sszevet\u00e9se\n                    nemzetk\u00f6zi irodalmi adatokkal. <jats:italic>M\u00f3dszer:<\/jats:italic> Magyarosz\u00e1gon eddig 12\n                    alkalommal v\u00e9gezt\u00fcnk v\u00e9gtagmegtart\u00f3 m\u0171t\u00e9tet malignus csonttumor miatt 12 \u00e9vesn\u00e9l\n                    fiatalabb gyermekekn\u00e9l, \u00e9s e m\u0171t\u00e9tek sor\u00e1n biol\u00f3giai rekonstrukci\u00f3s m\u00f3dszerk\u00e9nt\n                    extracorporalis irradiati\u00f3t, autograft-reimplantati\u00f3t (ECRT, ECI) v\u00e9gezt\u00fcnk. A\n                    m\u0171t\u00e9tek mindegyike primer malignus csonttumor (Ewing-sarcoma 7 esetben,\n                    osteosarcoma 4 esetben, chondrosarcoma 1 esetben) miatt t\u00f6rt\u00e9nt. Betegeink\n                    \u00e1tlag\u00e9letkora 9 (3\u201312) \u00e9v volt, az \u00e1tlagos ut\u00e1nk\u00f6vet\u00e9si id\u0151 32,5 (2\u201373) h\u00f3nap. A\n                    felm\u00e9r\u00e9s sor\u00e1n fizik\u00e1lis vizsg\u00e1lat, valamint minden alkalommal r\u00f6ntgenfelv\u00e9telek\n                    k\u00e9sz\u00edt\u00e9se t\u00f6rt\u00e9nt, sz\u00fcks\u00e9g eset\u00e9n sz\u00f6vettani mintav\u00e9tellel, v\u00e9relemz\u00e9ssel vagy\n                    egy\u00e9b k\u00e9palkot\u00e1ssal kieg\u00e9sz\u00edtve. Eredm\u00e9nyeinket nemzetk\u00f6zi irodalmi adatokkal\n                    hasonl\u00edtottuk \u00f6ssze. <jats:italic>Eredm\u00e9nyek:<\/jats:italic> Lok\u00e1lis tumorki\u00fajul\u00e1st\n                    egyetlen esetben sem \u00e9szlelt\u00fcnk, m\u00e1sik csontot \u00e9rint\u0151 skip (\u2019ugr\u00f3\u2019) metastasis\n                    miatt egy alkalommal amputati\u00f3t v\u00e9gezt\u00fcnk. A sz\u00f6v\u0151dm\u00e9nyek tekintet\u00e9ben\n                    eredm\u00e9nyeink megfelelnek a nemzetk\u00f6zi irodalomban le\u00edrtaknak. K\u00e9t esetben\n                    jelentkezett szeptikus sz\u00f6v\u0151dm\u00e9ny (16,7%). A resecti\u00f3s s\u00edk radiol\u00f3giai \u00e1t\u00e9p\u00fcl\u00e9se\n                    3\u20139 h\u00f3nap alatt t\u00f6rt\u00e9nt meg az esetek 60%-\u00e1ban. \u00c1l\u00edz\u00fclet, graftt\u00f6r\u00e9s, graft\n                    r\u00e9szleges elhal\u00e1sa miatt 3 esetben v\u00e9gezt\u00fcnk reoper\u00e1ci\u00f3t, k\u00e9tszer \u00fajabb\n                    allograft felhaszn\u00e1l\u00e1s\u00e1val, egy esetben pedig tumorprot\u00e9zis be\u00fcltet\u00e9s\u00e9vel.\n                    Betegeink szubjekt\u00edv v\u00e9lem\u00e9nye a m\u00f3dszerr\u0151l pozit\u00edv, a legt\u00f6bb esetben\n                    meg\u0151rizt\u00e9k j\u00f3 fizikai aktivit\u00e1sukat, az esetleges reoper\u00e1ci\u00f3k ellen\u00e9re\n                    v\u00e9gtagjukat terhelik, ak\u00e1r sporttev\u00e9kenys\u00e9get is v\u00e9geznek.\n                        <jats:italic>K\u00f6vetkeztet\u00e9sek:<\/jats:italic> Vizsg\u00e1latunk alapj\u00e1n az extracorporalis\n                    irradiatio hasznos biol\u00f3giai rekonstrukci\u00f3s m\u00f3dszer 12 \u00e9vesn\u00e9l fiatalabb\n                    gyermekek eset\u00e9ben szegment\u00e1lis csontdefektusok p\u00f3tl\u00e1s\u00e1ra tumoros indik\u00e1ci\u00f3val.\n                    A felmer\u00fcl\u0151 sz\u00f6v\u0151dm\u00e9nyek ar\u00e1nya alatta marad a hasonl\u00f3 korban be\u00fcltetett\n                    tumorprot\u00e9zisek sz\u00f6v\u0151dm\u00e9nyar\u00e1nyainak, ide\u00e1lis esetben pedig t\u00f6bb, tov\u00e1bbi\n                    kiterjesztett m\u0171t\u00e9t elker\u00fclhet\u0151 vele. Sz\u00f6v\u0151dm\u00e9ny eset\u00e9n a k\u00e9s\u0151bbiekben\n                    tumorprot\u00e9zis-be\u00fcltet\u00e9s mint v\u00e9gtagmegtart\u00f3 v\u00e9szmegold\u00e1s m\u00e9g mindig elv\u00e9gezhet\u0151.\n                    Orv Hetil. 2020; 161(45): 1914\u20131919.<\/jats:p>\n                <jats:p><jats:bold>Summary.<\/jats:bold> <jats:italic>Introduction:<\/jats:italic> Reconstruction of massive segmental bone defects\n                    is a crucial point of limb salvage surgeries after malignant bone tumor\n                    resections. Megaendoprostheses implantation is a commonly used method for adult\n                    patients, but hardly usable for children below 12 years old, because of the\n                    small size of the host bone and multiple mechanic complications.\n                        <jats:italic>Objective:<\/jats:italic> Extracorporeal irradiation and allograft\n                    reimplantation (ECRT, ECI) are promising methods for these young children for\n                    limb salvage, reducing the number of prostheses revisions, reoperations.\n                        <jats:italic>Method:<\/jats:italic> In Hungary, we performed limb salvage surgery for\n                    malignant bone tumor in 12 cases in children under 12 years old, using\n                    extracorporeally irradiated autografts as biological reconstruction. All cases\n                    were primary bone tumors (Ewing\u2019s sarcoma: 7, osteosarcoma: 4, chondrosarcoma:\n                    1). The average age of our patients was 9 (3\u201312) years, the average follow-up\n                    was 32.5 (2\u201373) months. At follow-up, we performed physical examination, X-ray,\n                    and other imaging methods if they were necessary. Our results were compared to\n                    international publications. <jats:italic>Results:<\/jats:italic> We observed no local\n                    recurrence, but in one case we had to perform above-knee amputation, due to a\n                    skip metastasis in the proximal tibia. The complication rates were similar to\n                    those reported in other papers. Septic complications were treated in two cases\n                    (16.7%). Total union of the resection lines was observed at 3\u20139 months in 60% of\n                    all cases. Reoperations were performed due to nonunion, or allograft\n                    fracture\/partly desorganization in 3 cases, twice with new allograft, and with\n                    prostheses in one case. The subjective opinion of our patients is positive, they\n                    walk with full weightbearing, some of them do even light sporting activities.\n                        <jats:italic>Conclusions:<\/jats:italic> We found extracorporeal irradiation a useful\n                    and safe method for children under 12 years old for biological reconstruction\n                    after malignant bone tumor resection. Complication rate stays under the rate of\n                    growing prostheses complications, in optimal cases further radical, and\n                    extensive surgeries may be avoided. In the case of major complications,\n                    megaendoprostheses implantation later on is still an option as salvage procedure\n                    with limb salvage. Orv Hetil. 2020; 161(45): 1914\u20131919.<\/jats:p>","DOI":"10.1556\/650.2020.31767","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T01:01:29Z","timestamp":1605056489000},"page":"1914-1919","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporalis irradiatio: nagy csontdefektussal j\u00e1r\u00f3 tumorresecti\u00f3t k\u00f6vet\u0151 biol\u00f3giai rekonstrukci\u00f3"],"prefix":"10.1556","volume":"161","author":[{"given":"Tam\u00e1s","family":"Perlaky","sequence":"first","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Ortop\u00e9diai Klinika, Semmelweis Egyetem, Budapest, \u00dcll\u0151i \u00fat 78\/b, 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"Kiss","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Ortop\u00e9diai Klinika, Semmelweis Egyetem, Budapest, \u00dcll\u0151i \u00fat 78\/b, 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kriszti\u00e1n","family":"Szalay","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Ortop\u00e9diai Klinika, Semmelweis Egyetem, Budapest, \u00dcll\u0151i \u00fat 78\/b, 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moghaddam Amin","family":"Maysam","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Ortop\u00e9diai Klinika, Semmelweis Egyetem, Budapest, \u00dcll\u0151i \u00fat 78\/b, 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"\u00c1goston","sequence":"additional","affiliation":[{"name":"2 Sug\u00e1rter\u00e1pi\u00e1s K\u00f6zpont, Orsz\u00e1gos Onkol\u00f3giai Int\u00e9zet, Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikl\u00f3s","family":"Szendr\u0151i","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Ortop\u00e9diai Klinika, Semmelweis Egyetem, Budapest, \u00dcll\u0151i \u00fat 78\/b, 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/650\/161\/45\/article-p1914.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/650\/161\/45\/article-p1914.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T01:13:42Z","timestamp":1633914822000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/650\/161\/45\/article-p1914.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,8]]},"references-count":0,"journal-issue":{"issue":"45"},"URL":"https:\/\/doi.org\/10.1556\/650.2020.31767","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,8]]}}}