New PDF release: Operative Treatment of Pelvic Tumors

By Tetsuro Morita (auth.), Hideaki E. Takahashi M.D., Ph.D., Tetsuro Morita M.D., Ph.D., Tetsuo Hotta M.D., Ph.D., Akira Ogose M.D., Ph.D. (eds.)

This e-book provides our event within the operative therapy of bone and soft-tissue tumors bobbing up in and round the pelvis, from 1970 to 1999 within the division of Orthopedic surgical procedure on the Niigata collage clinical medical institution. Histological diagnoses integrated either benign and malignant tumors. Surgical plan­ ning used to be tricky to accomplish in our early event in operative therapy, whilst merely angiography and barium enemas have been in use. meanwhile, computed tomog­ raphy scanning and magnetic resonance imaging turned on hand. next development within the caliber of those photos made three-d surgical plan­ ning for pelvic tumor elimination a lot more uncomplicated. Such growth in diagnostic methodolo­ gies, including developments in microsurgical ideas, equipment of irradiation, and diverse adjuvant chemotherapies has resulted in major advancements within the deal with­ ment of pelvic tumors. in addition, those developments have been greater by way of the avail­ skill of assorted traditional and personalized endoprostheses, plates and screws, spinal tools, and exterior fixators made from 3161 chrome steel, titanium, excessive­ density polyethylene, and ceramics. simply because sacral tumors are so silent and symptomless, they might develop to a wide measurement and be tricky to excise. removing of sacral tumors could make subjective signs worse as the sacrum includes the cauda equina. Excision of a tumor that contains the ilium and sacroiliac joint may well interrupt the structural balance of the pelvic ring. A tumor affecting the hip joint may well require reconstruction to re-establish the func­ of the hip and to supply balance for gait after operative treatment.

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Extra resources for Operative Treatment of Pelvic Tumors

Example text

11. Kirschner wires indicating the osteotomy line. Several Kirschner wires are introduced on the line of the osteotomy to guide the osteotome FIG. 12. Protection of the major vessels. A Mickliz sponge or a silicon plate is placed beneath the vessels to protect them from the osteotome, which is driven from the posterior approach cut level (Fig. 13). The upper cut level is also covered with a sponge or a silicon plate. The sacrum cannot be resected by the anterior approach only. Total Sacrectomy A combination of the anterior and posterior sacral approaches is essential for total sacrectomy.

Examination A CAT scan is superior to MR imaging for planning pelvic tumor surgery. A threedimensional CAT scan is the most powerful tool currently available. The space resolution of a CAT scan is better than that of an MR image. MR imaging frequently exaggerates the margin of the tumor, and makes it unclear. MR imaging is effective in detecting the intramedullary extent of a tumor, and its intramuscular invasion. Three-dimensional CAT scans provide a great deal of information which is helpful for planning the surgery using paper templates.

The sensitivity of the diagnosis of malignancy was 93%, and the specificity was 90%. The total accuracy rate was 91%. Histological diagnoses of tumors such as a chondrosarcoma or osteosarcoma were successfully made in 50% of the total number of aspirations. An Enneking's Stage II B (high-grade) tumor was easily aspirated from an extraosseous lesion. We developed a hole-in-one cannulated drill system for a fine needle. 5-mm-diameter Kirschner wire. When it is confirmed by an image intensifier or computerized axial tomography (CAT) scan that the tip of the Kirschner wire is positioned in the bone tumor, a fragile fine needle can be introduced easily and safely into the tumor.

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