Surgical Treatment Of Pelvic Malignant Tumors

Objective:To discuss the diagnosis,resection of tumors,reconstruction of defects and complication of pelvic malignant tumors.Methods:The clinical data of 26 cases of bone malignant tumors of pelvis from Jan 2002 to Dec 2006,were reviewed and analyzed retrospectively,which were from the 2^ndaffiliated hospital of Zhejiang University.The series comprised 12 males and 14 females with an medium age of 48 years old(range from 12 to 74 years old).26 cases of pelvic tumors were classified by Enneking partition:3 cases had lesion in regionⅠ,5 cases in regionⅡ,3 cases in regionⅢ,8 cases in regionⅠandⅡ,3 cases inⅡandⅢ,4 cases inⅠandⅣ.3 patients had local resection of pubis and ischium.Among those patients who had lesion in regionⅠorⅠandⅣ,1 patient had a wide resected without reconstruction;and another patient had suffergone reconstruction by allograft;5 patients were subjected reconstruction by TSRH system.Among those patients who had periacetabular tumor,6 were reconstrated by bone cement packing and total hip arthruplasty with reinforcement ring after resection;6 were resected hemipelvis without reconstruction;another 2 were subjected amputation. Curettage were be performed in 2 patients who had metastatic tumor.Patients would be suffered an combined therapy base on the type of pathology.Review the literature.Results:Among all the 26 cases,19 cases followed up from 3 to 57 months.13 cases were survived and had no local recurrence or metastasis.Local recurrence were found in 11.5%patients(3/26); complications were found in 26.9%patients(7/26);1 patient was subjected rectal injury;another dislocation of hip joint prosthesis. All of the 4 cases received regionⅠorⅢregion resection regained normal walking function.The hip joint function was normal in 5 cases suffered bone cement packing and hip joint replacement,ISOLS' core were range from 17 to 26.Although resulted in limb discrepancy,the function were very good and satisfacted whose without hip joint were be resected without reconstration(6 cases).5 patients suffergone reconstraction by TSRH system affer resected.And no breakage of nail or staff was observed in those patients,1～2 weeks after the operation all of them could train out of bed.Conclusions:Early diagnosis of pelvic tumors is very difficult;Selection a proper modality for resection and reconstruction is very important;reduction wound,prophylaxis and treatment for the complications actively are key points of surgical treatment.