Capanna R, Manfrini M, Pignatti G, Martelli C, Gamberini G, Campanacci M
I Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna.
Ital J Orthop Traumatol. 1990 Dec;16(4):425-37.
The authors report the results of 76 hemipelvectomies performed from 1978 to 1988 in malignant neoplasms of the hip region. Several surgical techniques were employed, including King and Steelquist's "classic" technique (77%), the technique involving the anterior flap of the thigh (9%), and the technique involving the subcutaneous gluteal flap (14%). In 8 cases palliative surgery was performed. Of the remaining 68 patients, 31 (45%) are alive and show no signs of the disease after an average of 44 months. Postoperative complications are discussed in relation to surgical technique and previous adjuvant therapy; the subcutaneous gluteal flap technique exposes the patient to the greatest risk of major complications (54%), while the "classic" technique is the most reliable, although there was superficial infection in 18% of cases. Fifty percent of the patients previously treated with radiotherapy suffered local postoperative complications. In order to reduce local recurrence, special care is advised in the preoperative stages and in the execution of the pelvic osteotomies.
作者报告了1978年至1988年期间对76例髋部区域恶性肿瘤患者实施半骨盆切除术的结果。采用了几种手术技术，包括金氏（King）和斯蒂尔奎斯特（Steelquist）的“经典”技术（77%）、涉及大腿前皮瓣的技术（9%）以及涉及臀下皮下皮瓣的技术（14%）。8例患者接受了姑息性手术。在其余68例患者中，31例（45%）存活，平均44个月后未出现疾病迹象。讨论了与手术技术和先前辅助治疗相关的术后并发症；臀下皮下皮瓣技术使患者面临主要并发症的最大风险（54%），而“经典”技术最可靠，尽管18%的病例出现了浅表感染。先前接受过放疗的患者中有50%术后出现局部并发症。为了减少局部复发，建议在术前阶段以及骨盆截骨手术实施过程中特别小心。
