Surgical outcome of Musculoskeletal Tumors of Pelvis.

Vimalakannan, M (2009) Surgical outcome of Musculoskeletal Tumors of Pelvis. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION : The bony pelvis and its enveloping soft tissues are a common site for bone and soft-tissue tumors. Five percent of primary malignant bone tumors involve the pelvis. Osteosarcoma in adolescents, Ewing’s sarcoma in children and chondrosarcoma in adults are the most common primary sarcomas in this location. More commonly, though, neoplasms involving the pelvis occur as a result of metastatic spread from the breast, lung, prostate, kidney or thyroid. Until the late 1970s most pelvic tumors were treated with External hemipelvectomy, a procedure that was associated with a significant percentage of complications and a dismal functional and psychological outcome. The 1st successful hemipelvectomy was reported by Charles Girard in 1895, for a recurrent osteosarcoma. With the advent of more accurate imaging modalities, newer chemotherapeutic agents, use of neoadjuvant chemotherapy, improved resection techniques, and prosthetic reconstruction, limb sparing procedures are now performed in the majority of these cases. Extensive pelvic surgeries are highly demanding because of the irregular and complex shape of the bony pelvis, numerous muscle attachments, and the proximity of major blood vessels, nerves, and visceral organs. Given the complexity of the anatomy and the use of adjuvant therapies that require an uncomplicated and expedient postoperative recovery, osseous pelvic resections remain one of the greatest surgical challenges. AIM : To analyze the surgical management of musculoskeletal tumors in pelvis. To analyze the morbidity & mortality associated with the management of musculoskeletal tumors in pelvis. To analyze the oncological & functional outcome of musculoskeletal tumors in pelvis and compare with that of literature. CONCLUSION : Bone and soft-tissue sarcomas that arise in the pelvis are difficult to treat. Tumors can be large and destructive before discovery, and they often involve vessels and nerves. Achieving a wide or even a marginal surgical resection margin may be technically complex at times. Historically, patients with pelvic tumors were treated with hemipelvectomies. These operations not only were fraught with complications but also in most cases represented physical, functional, and psychological problems for the patients. Several studies have described the difficulties patients have with such a procedure, and there is little doubt that regardless of the problems associated with the internal hemipelvectomies and reconstructions, such procedures are preferred to total limb ablation. Sacrectomy, one of the neglected & morbid operations, is feasible now with modified and improved surgical techniques.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Surgical outcome ; Musculoskeletal Tumors ; Pelvis.
Subjects: MEDICAL > Surgical Oncology
Depositing User: Kambaraman B
Date Deposited: 25 Jul 2017 04:06
Last Modified: 26 Jul 2017 03:00

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