Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press610.17650/2070-9781-2020-21-3-36-44BONE SARCOMASСАРКОМЫ КОСТЕЙComplications after endoprosthetic reconstruction for the tumor around the knee in children and adolescentsОсложнения онкологического эндопротезирования коленного сустава у пациентов детского и подросткового возрастаhttps://orcid.org/0000-0001-6313-6712BolshakovN.  A.БольшаковН.  А.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

bolshakovn@yandex.ruArtemovA. Y.АртемовА. Ю.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

VorochaiA.  М.ВорочайА.  М.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

https://orcid.org/0000-0002-6848-8714KonoplevaE. I.КоноплеваЕ. И.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

https://orcid.org/0000-0002-2021-0465SlininA. S.СлининА.  С.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

https://orcid.org/0000-0001-5679-8961TihonovaM. V.ТихоноваМ.  В.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

https://orcid.org/0000-0002-4451-3233GrachevN. S.ГрачевН. С.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

KarachunskyA.  I.КарачунскийА.  И.
Russian Federation

1 Samory Mashela St., Moscow 117997

117997 Москва, ул. Саморы Машела, 1

D. Rogachev National Medical Research Center of Pediatric Hematology, Oncology and ImmunologyФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России05072020122-336440504202105042021Copyright ©; 2020, Bolshakov N. ., Artemov A.Y., Vorochai A. ., Konopleva E.I., Slinin A.S., Tihonova M.V., Grachev N.S., Karachunsky A. .Copyright ©; 2020, Большаков Н. ., Артемов А.Ю., Ворочай А. ., Коноплева Е.И., Слинин А. ., Тихонова М. ., Грачев Н.С., Карачунский А. .2020Bolshakov N. ., Artemov A.Y., Vorochai A. ., Konopleva E.I., Slinin A.S., Tihonova M.V., Grachev N.S., Karachunsky A. .Большаков Н. ., Артемов А.Ю., Ворочай А. ., Коноплева Е.И., Слинин А. ., Тихонова М. ., Грачев Н.С., Карачунский А. .https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/6

The objective: аnalysis of complications after endoprosthetic reconstruction in children and adolescents according to the Henderson classification of failure of limb salvage surgery modified by the International Society of Limb Salvage committee (ISOLS).

Materials and methods.This study evaluates complications rates and mode of failures after endoprosthetic reconstruction for the tumor around the knee in 97 patients treated from 2012 to 2018 in D. Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology.

Results. Overall  19,6 %  of  failures  were  identified.  The  most  common  postoperative  complications  were  structural failu res, infection and soft-tissue failure (6,19; 5,15 and 3,1 % respectively). None of the developed failures affected the timing of treatment protocol.

Conclusion. Literature  review  and  the  study  results  demonstrate  that  higher  risk  of  failure  in  the  paediatric  group of patients is attributed to deficiency of adjacent soft-tissue and bone, skeletal immaturity, using of expandable endoprostheses and increased patient activity at this age. Multicenter studies are needed to optimize prevention and management of failures after endoprosthetic reconstruction.

Цель исследования – анализ осложнений онкологического эндопротезирования у пациентов детского и подросткового возраста с использованием последней версии классификации осложнений по E. R. Henderson, модифицированной комитетом ISOLS.

Материалы и методы.В статье представлен анализ осложнений эндопротезирования коленного сустава у паци-ентов  детского  и подросткового  возраста  с первичными  саркомами.  С 2012  по 2018 г.  в условиях  НМИЦ  ДГОИ им. Дмитрия Рогачева выполнено 97 эндопротезирований коленного сустава.

Результаты.Частота возникновения осложнений после онкологического эндопротезирования составила 19,6 %, при этом, согласно классификации ISOLS, наиболее часто они были представлены структурными повреждениями, инфекционными осложнениями и осложнениями, связанными с повреждением мягких тканей (6,19; 5,15 и 3,1 % соответственно). Ни в одном случае их развитие не повлияло на сроки проведения специфического лечения.

Заключение.Анализ литературы и результаты нашего исследования демонстрируют, что риск развития осложнений у данной возрастной группы обусловлен дефицитом мягких тканей и костной массы, незрелым скелетом, необходимостью использования раздвижных эндопротезов, повышенной физической активностью пациентов. В этой области необходимы мультицентровые исследования с целью оптимизации профилактики и тактики лечения.

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