Salai M, Garniek A, Rubinstein Z, Segal A, Morag B
Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.
J Surg Oncol. 1999 Jan;70(1):41-4. doi: 10.1002/(sici)1096-9098(199901)70:1<41::aid-jso7>3.0.co;2-q.
Pelvic tumors are often large and difficult to excise with appropriate surgical margins due to their size, proximity to neurovascular structures, and major intraoperative bleeding. The purpose of this study is to evaluate the yield of preoperative angiography and embolization so as to facilitate achievement of good surgical results.
Eighteen patients who suffered from large pelvic tumors (average size, 10.7 cm x 8.3 cm x 3.7 cm), 15 primary and 3 metastatic, underwent surgery at our institution between 1990 and 1995, after preoperative angiography and embolization of the tumors.
The efficacy of the procedure was high. In all but one patient, the grade of vascularity of the tumor was reduced by at least two levels (based on our new tumor vascularity scale. In most patients, appropriate surgical margins were achieved. The average perioperative blood loss was only 750 cc. Procedure-associated complications were negligible.
The results of this study call for the use of angiography and embolization in the management of patients with large pelvic tumors.
盆腔肿瘤通常体积较大，因其大小、与神经血管结构的毗邻关系以及术中大量出血，难以获得合适的手术切缘。本研究旨在评估术前血管造影和栓塞的效果，以利于取得良好的手术结果。
1990年至1995年间，18例患有大型盆腔肿瘤（平均大小为10.7 cm×8.3 cm×3.7 cm）的患者（15例原发性肿瘤，3例转移性肿瘤）在我院接受了术前肿瘤血管造影和栓塞后进行手术。
该手术效果良好。除1例患者外，所有患者肿瘤的血管分级至少降低了两级（基于我们新的肿瘤血管分级标准）。大多数患者获得了合适的手术切缘。围手术期平均失血量仅750 cc。与手术相关的并发症可忽略不计。
本研究结果表明，对于大型盆腔肿瘤患者的治疗，应采用血管造影和栓塞术。
