The Clinic Study: Reconstruction And Resection Of Pelvis Malignant Tumor

Objective: Pelvic is extremity important area ,which connects trunk and lower limbs .It contains many important organs, such as bladder, rectum, the female reproductive organs etc, and many important vascular and plexus . The pelvis and surrounding tissue is one of the connective tissue tumor sigmoidal. Because of the early symptoms are not obvious, discovered tumor is already in late,and pseudoaneurysm resection is bigger. Due to the postoperative patients lost half pelvis and ipsilateral lower extremities from the traditional half pelvic resection,patients offers huge trauma and disabled on the physical and mental . Over the past 20 years, with the development of new imaging, chemotherapy regimens use and technological progress,limb-salvage surgery has become the mainstream of the pelvis malignant tumor therapy allotted type method according to Enneking, according to the anatomic site where the tumor was grown, we divide the pelvis into 4 areas: Ilium is zoneⅠ; Acetabulum is zoneⅡ; Ichium and pubis is zoneⅢ; Ala sacralis is zone IV. The reconstruction and resection of ZoneⅠand zoneⅢis easier than zoneⅡ. This article will explore the pelvic tumor's resection, reconstruction and complications through the observion of our hospital's treatment of pelvic tumors.Methods: This paper was retrospectively analysed twelve patients's Clinical data and radiographic results.They were diagnosed with tumor of pelvis. Men and women are all six.Age for (19-66). 42.5 years old in average.All were followed up for 10-24 months, 17 months in average. According to the osteosarcoma classification of tumor.two cases are osteosarcoma, four cases are chondro sarcoma, two case is Ewing sarcoma, two cases are meta static tumor, one case is Plasma-Cell myeloma, one case is non Hodgkin B-lymphoma. According to Enneking pelvic tumor site division: six cases are inⅠarea; three cases are inⅡ+Ⅲarea;two casesare inⅠ+Ⅱ+ Ⅲarea ;one case is inⅡarea. Twelve patients preoperative were performed selectively tumor blood transarterial embolization, interventional therapy . Six patients have received the therapy that resection of pelvic tumor and reconstruction(two cases are artifical prosthetic replacement two cases are spinal nail bar system replacement ;two ases are nail bar system combined titanium network system replacement);the other patients have received the therapy that resection of pelvic,have not reconstruction.We analysis the operative time, perioperative blood transfusion, pelvic heal condition, lower limb length, the quality of life, and associated complications through the postoperative follow-up of patients.Results: All surgical were completed successfully.The patients with operations for exclusion of Pelvic tumor, their operation time was ranged from 2-4hours, 3hours in average. Intraoperatie blood transfusions were ranged from 1200-1800ml, 1400ml in average. Patients with operations for Structure and function reconstruction of Pelvic tumor was ranged from 6-7.5hours, 6.7hours in average. Intraoperatie blood transfusions were ranged from 2500-5000ml, 3500ml in average. The former patients's limb lengths are shortening in different degree (4.2-7.5cm), 5.7 cm in average.they can walk by the never lean after 3-5 months, then they can throw the never lean gradually. While the latter patients start to functional exercise in 4-5 weeks they can walk by the never lean after 2-3months, then they can throw the never lean gradually. According to International Society of Limb Salvage postoperative function evaluation standards, psychological, physical pain intensity, function, whether to need to support content, walking etc are to score.The former patients's score is 18.5 in average.The latter patients's score is 25.5 in averageConclusions:1 Operations for exclusion of Pelvic tumor ,the time of which is short ,less bleeding. the patient's expenses is light. Although patient's limb is short incertain degree, but postoperative patients' pain are disappeared. The stability and the weight capacity of limbs is still to be satisfied . They can walk independently without pain.This operation can reduce disablement rate 2 Using nail bar system combined titanium network system replacement in defect area bone graft treatment pelvic divisions I tumors。The district 1 tumors that defects serious after operation often need tobone graft ,which can ensure the integrity of the pelvis ring . Pedicle screw system can guarantee fixed indeed, strong, early postoperative burden. Titanium network system can prevent grafts shifting and achieve biological repair3Ⅱareas or I +Ⅱarea after tumor resection,half of Pelvic is lack.Adjustable artificially pelvic replacement therapy pelvic tumors which were designed by the professor WanPeng Xu. This artificially pelvis has simple structure, fixed firmly, convenient installation. Mechanical transmission closer to the physiological requirements, which retain and rebuilt the activity of the hip.Prosthesis surrounding bone graft can do biological repair, postoperative patients can be walking independently, pain disappeared.Compared with Operations for exclusion of Pelvic tumor can be early bed, activity function is good,which keeps the length of the lower limbs. Recent follow-up effect is satisfied4 Spinal nail bar system to rebuild pelvic ring treatmentⅣarea sacroiliac joints tumors, Because the sacrum after tumor resection, stayed largely cavity. The sacrum of surface lacks muscle layer, and local blood supply is poor, easy infection, which produces the cavity effusion. Excision of postoperative patients easy appear lumbar spinal instability, and consequential symptoms.. But nail bar system has the strongest resistance loading capacity, so that patients can early wear teams with bed activities, not because of spinal instability and produce the nerve root symptoms.5 The embolization of tumor ascularity all, can reduce bleeding, reduced the risk of surgery, has greatly improved the tumor complete resection and promote the efficacy of surgical treatment and the function satisfaction of postoperative...