骨盆恶性肿瘤切除后的修复与重建

Reparative and reconstructive following resection of malignant tumor for pelvic

目的 :探讨对骨盆肿瘤按其发生部位 ,选择相应术式 ,重建骨盆稳定性 ,最大限度保留肢体功能。方法 :1991～ 1994年 12例骨盆恶性肿瘤手术病人 ,Enneking 分期ⅡB 期 1例 ,ⅢB 期 1例 ,髂骨部肿瘤 (Ⅰ区 ) 7例 ;髋臼部肿瘤 (Ⅱ区 ) 3例 ;坐、耻骨肿瘤 (Ⅲ区 ) 2例。Ⅰ区肿瘤切除后均行自体肋骨架桥移植术。Ⅱ区肿瘤切除后髂股固定术或者连枷髋 ,Ⅲ区肿瘤切除坐耻骨。结果 :术后随访 6～ 2 4个月 ,所有病例均能保留患肢部分功能和骨盆稳定性。结论 :不同区域肿瘤切除术后选择不同的骨盆稳定性术式 ,可最大限度地保留肢体功能。提高生存质量。

Objective:To study surgical treatmemt of pelvic tumor in terms of the location of lesion in order to restore pelvic stability with less extent of damge of limb function.Methods:Twelve cases were treated by partial pelvic resection with limb salvage,11 patients with stage Ⅱ B and 1 patment with stageⅢ B.The location of the tumor was classified as being iliosacral (region Ⅰ),acetabular (region Ⅱ) and ischiopublic (regionⅢ).Reconstructive procedures were designed a rib strut graft following partial resection of illium for region Ⅰ;iliofemoral arthrosesis or flail hip for region Ⅱ and resection of ischiopubic for region Ⅲ.Results:Patients were followed up from 6 to 24 months. The limb function was preserved to some extent and pelvic stability was satisfactory.Conclusions:Different surgical treatment of stability of pelvic should be selected according to the site of pelive tumor and it is useful to retain limb function to great extent in improving the quality of life.