Abstract
The objective of this study was to present a simple, convenient, and reliable technique for the application of liquid nitrogen and to evaluate the effectiveness of curettage and cryosurgery. Between 1992 and 2002, 24 patients who had benign aggressive and low-grade malignant bone tumors were treated by curettage and cryosurgery. While cryosurgery was applied by the "direct pour" technique in the first seven patients, it was applied by the "pressurized spraying" technique in the others. Functional results were graded according to Enneking. The mean follow-up was 47 (range 9−131) months. There were no local recurrences. Three patients who underwent the direct pour technique developed partial skin necrosis. The functional results were excellent in 14 patients, good in six, and fair in four. When compared with previous reports on cryosurgery and its application techniques, we detected no tumor recurrence or complications, including soft-tissue injury, infection, and late fracture with liquid nitrogen applied by the pressurized spraying technique.
Résumé
L'objectif de cette étude était présenter une technique simple, pratique et fiable pour l'application d'azote liquide et évaluer l'efficacité du curetage avec cryochirurgie. Entre 1992 et 2002, vingt-quatre malades qui avaient des tumeurs osseuses bénignes agressives ou des tumeurs malignes de bas grade ont été traités par curetage et cryochirurgie. Cette cryochirurgie a été appliquée par versement direct chez les sept premiers malades, et par une technique de vaporisation chez les autres. Les résultats fonctionnels ont été notés d'après Enneking. Le suivi moyen était de 47 mois (9 −131). Il n'y avait pas de récidive locale. Trois malades qui ont subi le versement direct ont développé une nécrose cutanée partielle. Les résultats fonctionnels étaient excellents pour 14 malades, bons pour six, et médiocres pour quatre. En comparant avec les précédentes publications nous n'avons retrouvé ni récidive de la tumeur ni les complications incluant l'atteinte des parties molles, l'infection ou la fracture tardive lorsque l'azote liquide a été appliqué par la technique de vaporisation.
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