En bloc resection of extra-peritoneal soft tissue neoplasms incorporating a type III internal hemipelvectomy: a novel approach

World Journal of Surgical Oncology

Review

Norman D. Bloom¹  Sanjay S. Reddy² 

[1] Beth Israel Medical Center, Department of Surgery, 1st avenue at 16th street, 10003, New York, NY, USA;Fox Chase Cancer Center, Department of Surgical Oncology, 333 Cottman Avenue, 19102, Philadelphia, PA, USA;

关键词: Bloc Resection;    Malignant Peripheral Nerve Sheath Tumor;    Pelvic Ring;    Obturator Foramen;    Ischiorectal Fossa;   

DOI  :  10.1186/1477-7819-10-222

 received in 2012-04-13, accepted in 2012-10-15,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundA type III hemipelvectomy has been utilized for the resection of tumors arising from the superior or inferior pubic rami.MethodsIn eight patients, we incorporated a type III internal hemipelvectomy to achieve an en bloc R0 resection for tumors extending through the obturator foramen or into the ischiorectal fossa. The pelvic ring was reconstructed utilizing marlex mesh. This allowed for pelvic stability and abdominal wall reconstruction with obliteration of the obturator space to prevent herniations.ResultsAll eight patients had an R0 resection with an overall survival of 88% and with average follow up of 9.5 years. Functional evaluation utilizing the Enneking classification system, which evaluates motion, pain, stability and strength of the affected extremity, revealed a 62% excellent result and a 37% good result. No significant complications were associated with the operative procedure. Marlex mesh reconstruction provided pelvic stability and eliminated all hernial defects.ConclusionThe superior and inferior pubic rami provide a barrier to a resection for tumors that arise in the extra-peritoneal pelvis extending through the obturator foramen or ischiorectal fossa. Incorporating a type III internal hemipelvectomy with a simple marlex mesh reconstruction allows for complete tumor resection without functional compromise, acute infectious issues, obturator or abdominal hernia defects.

【 授权许可】

CC BY   
© Reddy and Bloom; licensee BioMed Central Ltd. 2012