Abstract
The five-year survival rate of osteosarcoma has gradually increased to 60% from 20% with Limb Salvage Surgery (LSS) combined with chemotherapy. Limb salvage surgery involves two main steps, wide resection of the bone tumor, followed by reconstruction of the defect. Reconstruction can be achieved with Cryosurgery.
In this study, we presented a serial case of four patient at RSUP Dr. Moh. Hoesin Palembang with ages between 13-19 years old, 2 male and 2 females and diagnosed with Osteosarcoma Enneking stage IIB at the Lower Extremity Region that treated with Cryosurgery from October 2020- February 2021.
The cryosurgery procedure on RSUP dr. Moh Hoesin Palembang, started with the bone soaked into liquid Nitrogen for 20 minutes. The bone than thawed at room temperature for 15 minutes and then soaked with normal saline in room temperature for another 15 minutes. The used of Cryosurgery for limb salvage surgery shown a good result for inducing osteosarcoma necrosis with all Histopathology results shown 50-90% to 91-99% post cryosurgery (Huvos grade II-III).
The followed up however shown mixed results, with the patients have mixed knee flex ranged from 40o to 1100, but The LLD could still be preserved at 1-2 cm. During Followed up at 1-2 month postoperative, we found complication such as failure of fixation and skin necrotic. The followed-up research also still needed for long termed results, complications and for assessing the recurrency rated of the Osteosarcoma for these cases.
Keywords
- homocysteine
- MTHFR
- circumventricular organ
- magnesium
- vitamin D
- CD147