Affiliation:
1. P.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation
Abstract
Surgical treatment of patients with tumoral defeat of pelvic bones, of preacetabular region, in particular, is one of the most challenging topics of modern oncorthopedics. Currently, one of the most modern methods of reconstruction of the pelvic bones is the use of modular endoprostheses based on the conical leg, the advantage of which is the ability to intraoperatively simulate an endoprosthesis that best meets the specific clinical situation. Purpose of research. To assess the benefits of modular endoprosthesis of the acetabulum in patients with tumoral defeat periacetabular region.Patients and methods. Within the period of 2011–2018 30 patients underwent surgical treatment in form of periacetabular resection with a modular endoprosthesis reconstruction in P.Hertsen Moscow Oncology Research Institute – Branch of National Medical Research Radiological Centre of Ministry of Health of Russian Federation. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary bone cancers were in 19 (63%) patients, giant cell tumors in 5 (17%), locally advanced soft tissue sarcoma in 1 (3%), solitary metastases of kidney cancer in 2 (7%), and recurrent sarcomas after previous surgical treatment in 3 (10%) patients.Results. The average duration of the operation was 310 min (145–520 min), the volume of intraoperative blood loss was 5520 ml (600–20 000 ml). The positive edge of resection according to the results of the planned morphological study was revealed in 3 (10%) patients. The average follow-up period was 36 months (4-73 months). Disease progression in terms of 6 to 40 months was revealed in 10 (33%) patients. 8 (27%) patients from disease progression. Complications of different types were diagnosed in 11 (37%) patients, among whom infectious complications prevailed 9 (30%). The average value of the functional results on a scale MSTS accounted for 59% (15 to 82%). Conclusion. The use of modular systems of endoprosthesis replacement of the acetabulum and hip joint in tumor lesions is a promising surgical technique that allows to achieve adequate functional results with a comparable number of postoperative complications.
Subject
Microbiology (medical),Immunology,Immunology and Allergy
Reference31 articles.
1. Kaprin AD, Starinskij VV, Petrova GV. Zlokachestvennye novoobrazovaniya v Rossii v 2014 godu (zabolevaemost’ i smertnost’) [Incidence of malignant neoplasms 2014 in the population of Russia (incidence and mortality]. Мoscow: P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation; 2016, pp. 10–16. (In Russian).
2. Grimer RJ, Chandrasekar CR, Carter SR, Abudu A, Tillman RM, Jeys L. Hindquarter amputation. Bone Joint J. 2013 Jan;95-B (1):127–31. DOI: 10.1302/0301–620X.95B1.29131
3. Higinbotham NL, Marcove RC, Casson P. Hemipelvectomy: A clinical study of 100 cases with five year follow-up on 60 patients. Surgery. 1966 May;59 (5):706–8.
4. Karakousis CP, Vezeridis MP. Variants of hemipelvectomy. Am J Surg. 1983 Feb;145 (2):273–7.
5. Derzhavin VA, Karpenko VYu, Bukharov AV, Volchenko NN, Yadrina AV, Ivanova MV. Modular endoprosthetic replacement of the periacetabular region in the tumor involvement of the acetabulum and hip joint. Preliminary results. Onkologiya. Zhurnal imeni P. A. Gerzena (P. A. Herzen Journal of Oncology). 2018;7 (2):26– 32. DOI: 10.17116/onkolog20187226–32 (In Russian).