Surgical Treatment Of Giant Cell Tumor Of The Distal Radius:A Meta-analysis

Objective:Surgical treatment of giant cell tumor of the distal radius(GCTDR)is still controversial because of the risk of recurrence and limitation of wrist function.Surgical treatment is mainly within tumor lesions curettage and wide resection,intralesional curettage range,less damage,has disadvantage of high recurrence rate;low recurrence rate after wide resection,but there is a wide range of surgical injury and intraoperative and postoperative complications of reconstruction difficult,limited wrist function defect therefore,the surgical treatment of giant cell tumor of bone of distal radius is still controversial.A Meta analysis of this paper,the treatment of high quality search at home and abroad have been published about the comparison of giant cell tumor of the distal radius surgical literature,comparison of radius distal to the lesion in the giant cell tumor of bone curettage with or without adjuvant therapy with wide resection in the treatment of postoperative recurrence rate,complication rate and wrist function rehabilitation clinical research results evaluation and quantitative analysis,comparison of radius distal to the lesion in the giant cell tumor of bone resection and excellent wide resection,provide evidence-based reference for the surgical treatment of giant cell tumor of bone of distal radius.Method:By searching Medline Cochrane,Pubmed,Library,Ovid,Elsevier,Chinese Journal Full-text Database(CNKI)and Wan Fang database retrieval journals published at home and abroad about the comparison of distal radius giant cell tumor of bone curettage and extensive resection of the literature,in strict screening studies that met the inclusion criteria,and quality evaluation of the literature,using the Cochrane collaboration's Review 5.3 software Manager combined with analysis,and to test for heterogeneity of data.Results:A total of 13 articles were collected,including 313 samples,including 114 cases in China and 199 cases abroad.Excluding the visit and ulnar cases,there were 289 cases in total,including 142 cases in tumor curettage group and 147 cases in tumor wide resection group.The results were as follows: 1.The total number of cases in the tumor resection group was 176 cases.Analysis of wrist function score between the rate of operation and postoperative complications in two groups after the recurrence rate,the Review Manager 5.3 software.The analysis results showed : intralesional curettage group the postoperative recurrence rate is higher than that of the tumor wide resection group,OR = 5.50,95%CI(2.45,12.33),P < 0.0001 lesions;The curettage group combined with bone graft or bone cement(PMMA)in adjuvant treatment of postoperative recurrence rate similar to that of the bone cement group was better than the bone graft group,OR = 1.04,95%CI(0.28,3.86),P = 0.95;intralesional curettage postoperative complication rate is lower than the tumor wide resection group,OR =0.25,95%CI(0.12,0.52),P = 0.0002;by using the MSTS system,the VAS evaluation system evaluation and evaluation system strength,intralesional curettage group in rehabilitation results is better than that of the tumor resection group,wrist lesions in the hepatectomy group The excellent and good rate of node function was higher than that of tumor resection group(OR = 4.84,95%CI(1.17,20.13),P = 0.03).Conclusion:With intralesional curettage and tumor wide resection in the treatment of distal radius bone giant cell lesion resection group,postoperative recurrence rate than tumor segment resection group,intralesional curettage of bone graft with bone cement adjuvant therapy and adjuvant treatment of both the postoperative recurrence rate had no obvious advantages,the postoperative recurrence rate and the main operation the resection range of intralesional resection;postoperative complication rate is higher than that of tumor segment resection group;rehabilitation results intralesional resection group after surgery than most tumor segment resection group;for Campanacci 3 stage distal radius giant cell tumor,extensive resection can reduce the recurrence rate and avoid the possibility of reoperation after recurrence.