32 cases of peripheral nerve injury in surgical tr

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32 cases of peripheral nerve injury in surgical treatment

Metastasis, indicating a high amputation in the treatment of osteosarcoma could not improve the survival rate after a century of reason. Now that osteosarcoma should be considered as a systemic disease, local tumor cure is not the key to cure the disease, the key is the small potential for systemic treatment of metastases. Rosen first proposed in 1977, so the concept of neoadjuvant chemotherapy, postoperative chemotherapy would be a simple change of preoperative chemotherapy for a method of surgical treatment of repeated chemotherapy of osteosarcoma. Specific contents: ① timely preoperative chemotherapy, the eradication of systemic micrometastases; ② control of the primary tumor,[link widoczny dla zalogowanych], so that limb salvage surgery have been implemented; ③ after histological examination of tumor specimens, according to tumor cell necrosis, preoperative chemotherapy to determine effect, develop a reasonable program of postoperative chemotherapy; ④ to continue chemotherapy after surgery to prevent tumor recurrence and metastasis. 7O's methotrexate appears (MTX), adriamycin (ADR) and cisplatin (CDP) has become the major chemotherapy drugs. Preoperative chemotherapy to improve the survival rate of patients is not valid, the new 1). 80 Application RosenT. Statistics of 87 cases chemotherapy in patients with osteosarcoma after 5-year survival rate was 82%. chemotherapy can effectively eliminate sub f clinical metastasis. reduce f} fl metastasis and recurrence. improved the survival rate of osteosarcoma. is not a complementary, palliative clear boil, is a major life-saving measures. preoperative chemotherapy through veins, arteries and two-way delivery. vein, effective drugs, the clinical lesions and early treatment of micrometastases. Artery survival rate did not affected the local recurrence rate of 5 cases, and amputation were similar. preoperative chemotherapy on the effectiveness of the tumor, determined by the following points: ① Clinical manifestations: disappearance or alleviation of local pain; tumor surface skin temperature decreased , edema, hard texture, reduce venous engorgement; smaller tumor volume, increased joint mobility nearby. ② Biochemical: decrease of alkaline phosphatase, creatine kinase increased in some patients. ③ imaging: x-ray film: the tumor is reduced, soft tissue edema, clear boundaries, edges appear ossification or calcification; angiography: blood supply and abnormal blood vessels decreased. ① pathological assessment: The most accurate indicator compared with chemotherapy prior to biopsy sections assessment of tumor necrosis rate of small roar. Ayala grading standards that the necrosis rate 9O ~ 100 for the complete response rate of 6O ~ 9O necrosis as part of the anti-J Li, in the 6O following no response. tumor cell response to preoperative chemotherapy is an important factor to determine their prognosis, there are still 1O ~ 25 osteosarcoma patients with poor response to existing chemotherapy regimens, there is l because tumor cells are resistant to chemotherapy. how to improve the preoperative chemotherapy, the proportion of patients fully effective, strengthening the degree of preoperative chemotherapy dose, early identification of patients with poor efficacy, given the appropriate chemotherapy, improving the survival and development of new chemotherapy drugs, reduced side effects of chemotherapy in the future development of osteosarcoma.

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