Fox Chase Cancer Center, Department of Surgical Oncology, 333 Cottman Avenue, Philadelphia, PA 19102, USA.
World J Surg Oncol. 2012 Oct 25;10:222. doi: 10.1186/1477-7819-10-222.
A type III hemipelvectomy has been utilized for the resection of tumors arising from the superior or inferior pubic rami.
In 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.
All 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.
The 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.
III 型半骨盆切除术已用于切除起源于耻骨上或下支的肿瘤。
在 8 例患者中，我们采用 III 型内半骨盆切除术，对通过闭孔或坐骨直肠窝延伸的肿瘤进行整块 R0 切除。骨盆环采用 Marlex 网重建，以实现骨盆稳定性和腹壁重建，同时闭塞闭孔间隙以防止疝出。
所有 8 例患者均行 R0 切除术，总生存率为 88%，平均随访 9.5 年。利用 Enneking 分类系统（评估受累肢体的运动、疼痛、稳定性和力量）进行功能评估，结果显示 62%为优秀，37%为良好。手术过程无明显并发症。Marlex 网重建提供了骨盆稳定性，消除了所有疝缺损。
耻骨上支和耻骨下支为起源于腹膜外骨盆的肿瘤提供了一个屏障，这些肿瘤通过闭孔或坐骨直肠窝延伸。采用 III 型内半骨盆切除术和简单的 Marlex 网重建可实现完全肿瘤切除，不会造成功能损害、急性感染问题、闭孔或腹部疝缺损。
