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[Classification and related operation procedures of pelvic tumor treated with partial pelvic resection]
1Orthopedic Department of General Hospital of People's Liberation Army, Beijing 100853.
Objective:
To establish a classification system of pelvic tumor in terms of the location of lesion in order to project surgical treatment with less extent of damage to the affected limb function.
Method:
Thirty-six cases were treated by partial pelvic resection with limb salvage, and 20 were followed up. The lesions were divided into four groups on the basis of sacral-iliac and/or hip joint involved. In group I, lesion was noted in the ischium or pubis only;in group II the lesion was located at sacral-iliac joint or hip joint. The patients with acetabulum involved were classified into group III both sacral-iliac joint and hip joint were destroyed by tumor in group IV. Surgical treatment was designed as resection, resection with sacral-iliac joint reconstruction, resection without hip joint reconstruction according to the classification of the lesion. The patients in group IV were treated with traditional hemi-pelvic amputation.
Result:
Patients were followed up from 4 months to 14 years (average 51.7 months). The limb function was preserved to some extent, and pelvic stability was satisfactory. Walking gait was not chlanged significant in group I and II. But resection without hip joint reconstruction in group III resulted in limb discrepancy (4.0 - 8.0 cm) and walking lamely. The patients needed custom-made shoes with heightened heel, but some of them walked with crutch when the discrepancy exceeded 8 cm. There were no nerve and vessel injury in the long run. The strength of muscles around hip joint was III - IV grade after postoperative exercise, and the capability of walking and viability recovered 3 months after the operation.
Conclusion:
Different surgical treatments should be selected according to the site of pelvic tumor. The classification system depending on the lesion's location in pelvic tumor is useful in selecting operative procedure to retain limb function to great extent.