Alauddin KOCHAİ, Buğra ALPAN, Ünal ERKORKMAZ, Harzem ÖZGER

Ameliyat Tekniği, Yaş, Cinsiyet ve Lezyonun Bölgesi Nüks Oranını Etkiler Mi? Anevrizmal Kemik Kistinin (AKK) Epidemiolojik Çalışması

Amaç:Anevrizmal kemik kistinde tedavi tekniği,lezyonun anatomik bölgeleri, cinsiyet ve yaşınnüksoranlarıüzerindekietkilerivegörülmesıklığınınnaraştırılması.Gereç ve Yöntemler:Kliniğimizdeanevrizmal kemik kisti tanısıyla100hasta, geriye dönükolarakçalışmaya alındı. Çalışmamızdaparametreolarak farklıtedavitekniklerin nüksoranları,cinsiyeteve lezyonun lokalizasyonuna göregörülmesıklığıvenüksoranıelealındı.Bulgular:Hastaların45’ikadın,55’ierkek idi. Ortalama yaşı22(4-56)idi. Hastaların%54’iyirmi yaşınaltındaydı.22’siüstekstremite,55’ialt ekstremite ve 23’üpelvis ve vertebra’dankaynaklanıyordu.31’iküretajsonrasısementleme, 57’siküretajsonrasıgrefonajve 12’sirezeksiyonile tedavi edilmiş. Ortalamatakipsüremiz64,6(1-216) aydı.Toplam 16 (%22,53) nüksgörüldü.Buhastalarınbirinde2,birinde3keznüksgörülmüş. Nükslerinbirihariçhepsitedavidensonraki ilk iki sene içindegörülmüş. Bir hastada 9 yıl7aysonra nüksgörülmüş.Nükslerin8’ialt ekstremiteden 5’iüstekstremiteden ve 3’üpelvistenkaynaklanıyormuş. Nükslerin1’ibirincionyıllıkdönemde,8’iikincionyıllıkdönemde,6’sıüçüncüonyıllıkdönemdeve1’i(%6,25)dördüncüonyıllıkdönemdegörülmüş.Küretajsonrasıgrefonaj yapılmışhastaların%21.05’unda nüksgörülmüş. Küretajsonrasısementleme yapılanhastaların%12,90’indenüksgörülmüş.Sonuç:Agresif tedavi yapılanlardanüksolanıazaldığıgörülmekteancakküretaj-grefonajveyaküretaj-sementlemegibiyöntemlereekolarakadjuvantedavilerlekabul edilebilir sonuçlareldeedilebilir.Agresiftedavininrekonstrüksiyonuçokdahazorolacağıiçinnilktedaviseçeneğiolarakagresifyöntemlerkullanılmamasınıöneriyoruz.Nükslerinçoğuoperasyondansonrakiilkikiseneiçindegörüldüğüiçin,opereedilen lezyonlar en az iki sene takip altındatutulmalıdır.

Anahtar Kelimeler:

Anevrizmal kemik kisti, Nüks, Küretaj, Patoloji

Does Treatment Technique, Age, Sex and Lesion Side Effect the Rate of Recurrence? An Epidemiologic Study of Aneurysmal Bone Cysts

Objective We aimed to present the outcomes of primer aneurysmal bone (PABC) cysts ( Sakarya Med J, 2018, 8(3):593-602 ).Materials andMethodsOne hundred patients with PABC were included in this study. We investigated age, sex, location, treatment technique and recurrence ratesResults Forty-fi ve patients were female and 55 patients were male. The mean age was 22 (4-56). %54 (54) of the patients were on the fi rst and second decade. %22 (22) lesions were located in upper extremity, %55 (55) were in lower extremity and 23 (23) were in pelvis and vertebra.Fifty-seven were treated by curettage with or without bone grafting, 31 with curettage and cementation and 12 with resection. The meanfollow-up period was 64,6 months (25-120). All of the lesions were PABC.The total recurrence was 16 (%16). Fifteen recurrences were seen in the fi rst two year. Eight of them were in the lower extremity, 5 of themwere upper extremity, 3 recurrences were at the pelvis. One of the recurrence was seen at the fi rst decade, 8 of the recurrences were seenat the second decade, 6 of the recurrences were seen at the third decade and 1 of the recurrence was seen at the fourth decade. %21.05 ofthe patients who were treated by curettage with or without grafting had recurrence. %12.90 of the patients who were treated by curettageand cementation had recurrence. None of the patients who had treated by resection had recurrence.Conclusion Aggressive surgery decreases the recurrence rate but curettage with or without grafting or with cementation and adjuvant treatments alsoprovide good results

Keywords:

Aneurysmal Bone Cyst, Recurrence, Curettage, Pathology,

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