Surgical Guides (Patient-Specific Instruments) for Pediatric Tibial Bone Sarcoma Resection and Allograft Reconstruction
Identifieur interne : 001830 ( Main/Exploration ); précédent : 001829; suivant : 001831Surgical Guides (Patient-Specific Instruments) for Pediatric Tibial Bone Sarcoma Resection and Allograft Reconstruction
Auteurs : Laura Bellanova [Belgique] ; Laurent Paul [Belgique] ; Pierre-Louis Docquier [Belgique]Source :
- Sarcoma [ 1357-714X ] ; 2013.
Abstract
To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI) and computerized tomography (CT) were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument) that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.
Url:
DOI: 10.1155/2013/787653
PubMed: 23533326
PubMed Central: 3603296
Affiliations:
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type="wicri:Area/Main/Exploration">001830</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Surgical Guides (Patient-Specific Instruments) for Pediatric Tibial Bone Sarcoma Resection and Allograft Reconstruction</title><author><name sortKey="Bellanova, Laura" sort="Bellanova, Laura" uniqKey="Bellanova L" first="Laura" last="Bellanova">Laura Bellanova</name><affiliation wicri:level="3"><nlm:aff id="I1">Computer-Assisted Robotic Surgery (CARS), Institut de Recherche Experimentale et Clinique (IREC), Tour Pasteur +4, Avenue Mounier 53, 1200 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Computer-Assisted Robotic Surgery (CARS), Institut de Recherche Experimentale et Clinique (IREC), Tour Pasteur +4, Avenue Mounier 53, 1200 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Department of Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, (Université Catholique de Louvain), Avenue Hippocrate 10, 1200 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, (Université Catholique de Louvain), Avenue Hippocrate 10, 1200 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation></author><author><name sortKey="Paul, Laurent" sort="Paul, Laurent" uniqKey="Paul L" first="Laurent" last="Paul">Laurent Paul</name><affiliation wicri:level="3"><nlm:aff id="I1">Computer-Assisted Robotic Surgery (CARS), Institut de Recherche Experimentale et Clinique (IREC), Tour Pasteur +4, Avenue Mounier 53, 1200 Brussels, Belgium</nlm:aff><country 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sort="Docquier, Pierre Louis" uniqKey="Docquier P" first="Pierre-Louis" last="Docquier">Pierre-Louis Docquier</name><affiliation wicri:level="3"><nlm:aff id="I1">Computer-Assisted Robotic Surgery (CARS), Institut de Recherche Experimentale et Clinique (IREC), Tour Pasteur +4, Avenue Mounier 53, 1200 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Computer-Assisted Robotic Surgery (CARS), Institut de Recherche Experimentale et Clinique (IREC), Tour Pasteur +4, Avenue Mounier 53, 1200 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Department of Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, (Université Catholique de Louvain), Avenue Hippocrate 10, 1200 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, (Université Catholique de Louvain), Avenue Hippocrate 10, 1200 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation></author></analytic><series><title level="j">Sarcoma</title><idno type="ISSN">1357-714X</idno><idno type="eISSN">1369-1643</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI) and computerized tomography (CT) were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument) that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Winkler, K" uniqKey="Winkler K">K Winkler</name></author><author><name sortKey="Bielack, S" uniqKey="Bielack S">S Bielack</name></author><author><name sortKey="Kempf Bielack, B" uniqKey="Kempf Bielack B">B Kempf-Bielack</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Paulussen, M" uniqKey="Paulussen M">M Paulussen</name></author><author><name sortKey="Ahrens, S" uniqKey="Ahrens S">S Ahrens</name></author><author><name sortKey="Dunst, J" uniqKey="Dunst J">J Dunst</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Grimer, Rj" uniqKey="Grimer R">RJ Grimer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Muscolo, Dl" uniqKey="Muscolo 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last="Bellanova">Laura Bellanova</name></region><name sortKey="Bellanova, Laura" sort="Bellanova, Laura" uniqKey="Bellanova L" first="Laura" last="Bellanova">Laura Bellanova</name><name sortKey="Docquier, Pierre Louis" sort="Docquier, Pierre Louis" uniqKey="Docquier P" first="Pierre-Louis" last="Docquier">Pierre-Louis Docquier</name><name sortKey="Docquier, Pierre Louis" sort="Docquier, Pierre Louis" uniqKey="Docquier P" first="Pierre-Louis" last="Docquier">Pierre-Louis Docquier</name><name sortKey="Paul, Laurent" sort="Paul, Laurent" uniqKey="Paul L" first="Laurent" last="Paul">Laurent Paul</name><name sortKey="Paul, Laurent" sort="Paul, Laurent" uniqKey="Paul L" first="Laurent" last="Paul">Laurent Paul</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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