Local wide excision of scapula tumor

Children's bone tumors include primary and secondary bone tumors. Primary bone tumors refer to benign bone tumors, malignant bone tumors and tumor-like lesions originating from bone tissue. Secondary bone tumors refer to other organ malignant tumors. A tumor of bone tissue. Clinically, benign bone tumors and tumor-like lesions are more common. Among malignant bone tumors, osteosarcoma is the most common. In recent years, due to the advancement of surgical techniques, the establishment of surgical system of bone tumor surgery and the extensive application of adjuvant chemotherapy before and after surgery have significantly improved the surgical treatment of bone tumors. The 2-year tumor-free survival rate has increased from 30% to 80%. Moreover, amputation is no longer the first choice for the treatment of malignant bone tumors. Many scholars advocate the use of local extensive or local radical bone tumor resection and limb preservation surgery, that is, surgical removal of tumor lesions, and the use of adjuvant chemotherapy to eliminate the occurrence of Microscopic metastatic lesions. Treatment of diseases: chondrosarcoma, giant cell tumor of bone Indication Local extensive resection of the scapula tumor is applicable to: 1. Low-grade malignant tumor of the scapula, including giant cell tumor of the bone and chondrosarcoma. 2. Preoperative CT and MRI showed that the vascular nerve bundles were not involved, and the surgical staging was stage I and stage IIA. 3. The sick child and his parents have a wish for limb salvage. Contraindications 1. Surgical staging is stage III. 2. Preoperative CT and MRI showed vascular nerve bundle involvement. Preoperative preparation 1. CT and MRI examination to determine the extent of bone tumor involvement. 2. Chest X-ray and whole body radionuclide bone scan, except for lung metastasis and bone metastasis. 3. Biopsy clear pathological diagnosis. Surgical procedure Incision The incision starts from the top of the shoulder and reaches the inferior corner of the shoulder blade along the outer upper. 2. Reveal Cut the skin and superficial fascia along the direction of the incision, retain the deep fascia, and free the flaps on both sides. The trapezius muscle is revealed, and the self-stopping point is cut and then pulled upward and inward. Then the supraspinatus, infraspinatus, great round, small round and latissimus dorsi are revealed. The deltoid muscle is cut off at the lateral edge of the shoulder and the latissimus dorsi is cut at the lower scapula. After turning the latissimus dorsi downward, the scapula is everted and the size of the rhomboid muscle and the scapula levator muscle are cut. The shoulder joint is then abducted to cut the muscles at the attachment points of the scapula: the big round muscle, the small round muscle, the triceps long head, the supraspinatus muscle, the infraspinatus muscle, and the anterior serratus. 3. Tumor resection The rear and upper sides of the shoulder joint are exposed, and the osteotomy is performed near the shoulder peak with a wire saw or a bone knife, and then the shoulder neck is cut along the direction of the shoulder scapula, and the scapula with the tumor is taken out. 4. Functional reconstruction After completely stopping bleeding, the tendons of the trapezius and deltoid muscles are sutured together, and the tendons of the large round muscle and the small round muscle are sutured together and fixed on the chest wall. 5. Close the incision After the physiological saline was washed, the incision was sutured in layers, and a vacuum suction tube was placed in the incision.