Tiwari Akshay, Yadlapalli Anilkumar, Verma Vivek
Musculoskeletal Surgical Oncology Division, Musculoskeletal Oncology Disease Management Group, Max Institute of Cancer Care, New Delhi, India.
J Clin Orthop Trauma. 2020 Aug 28;13:63-65. doi: 10.1016/j.jcot.2020.08.016. eCollection 2021 Feb.
Internal hemipelvectomy is a surgically challenging entity, owing, among other reasons, to a complex anatomy. The apprehension of an inadequate margin or injury to critical structures adds to the complexity of these major surgical procedures. Computer assisted tumor surgery (CATS) has been increasingly used to improve outcomes of internal hemipelvectomy over the last decade. We analyzed the surgical and postoperative details of first four patients undergoing internal hemipelvectomy with CATS assistance at our institute, the first ever report in an Indian setting. The patients were analyzed for blood loss (mean 1300 ml), operative time (mean 306 min) and hospital stay (mean 7 days). The histopathological margins were free of disease in all the patients, even as the average closest bony margin was 0.9 cm. Sparing of sacral nerve root was made possible by the close yet free margins in two patients. In this retrospective analysis of a small series of patients with computer navigation assisted internal hemipelvectomy, we found this technique to be feasible and effective in achieving the oncological aim of negative margins with preservation of critical structures.
半骨盆内切除术是一种手术难度较大的术式，原因之一在于其解剖结构复杂。担心切缘不足或损伤关键结构增加了这些大型外科手术的复杂性。在过去十年中，计算机辅助肿瘤手术（CATS）越来越多地被用于改善半骨盆内切除术的效果。我们分析了在我院接受CATS辅助半骨盆内切除术的前四名患者的手术及术后详细情况，这是印度首例此类报告。对患者的失血量（平均1300毫升）、手术时间（平均306分钟）和住院时间（平均7天）进行了分析。所有患者的组织病理学切缘均无病变，尽管平均最近骨切缘为0.9厘米。两名患者切缘紧密但无病变，得以保留骶神经根。在对一小系列计算机导航辅助半骨盆内切除术患者的回顾性分析中，我们发现该技术在实现切缘阴性的肿瘤学目标并保留关键结构方面是可行且有效的。
