Evaluation Of Pelvic Malignant Bone Tumor After Resection And Reconstruction

Objective:This paper retrospectively studies the shanxi medical university second clinical hospital’s collection of 23 routine limb-salvage surgery patients cases,explore the pelvis Ⅰ area-Ⅲ area of malignant bone tumor resection and reconstruction after curative effect evaluation.Methods:A retrospective study was conducted on 23 patients with pelvic malignant bone tumors who underwent mb salvage surgery in the second clinical hospital of shanxi medical university from 2010 to 2018.The surgical methods studied included tumor resection,mechanical internal fixation with plate screws or pedicle screws,reconstruction with ipsilateral iliac bone graft or allograft,and artificial hemipelvis replacement.The most effective evaluation system,MSTS,was used to evaluate the postoperative functional recovery of patients.Kaplan-meier method was used to calculate the survival rate.The statistical software was spss21.0.The statistical method was the t-test of a single sample(T<0.05).Results:There were 23 patients,including 12 males and 11 females.Age 19-78,22 cases of primary tumors,metastatic carcinoma in 1 case,including Ⅰ area 13 cases,involving Ⅱ area in 5 cases,Ⅲ area in 5 cases,2 cases of 23 cases patients of wound infection symptoms,to effectively control infection after use of antibiotics,patients with more than no obvious rejection,mechanical failure occurred,deep infection,perioperative death and other serious complications.Among the 23 patients undergoing limb salvage surgery,12 patients had local tumor recurrence or distant metastasis,and those with local tumor recurrence died of lung metastasis after local tumor recurrence until the end of follow-up.Up to the end of follow-up,one patient needed to walk on crutches,while the rest did not.Gait of patients have different degree of change,to be a limp,and according to the MSTS scale,postoperative function in patients with grade pure Ⅰ area is 60.0%-90%,involving Ⅱ area 60.0%,73.3%,73.3%,83.3% pure Ⅲ area.None of the 23 patients was lost to follow-up,and by the end of the follow-up period,12 patients died and 11 survived.None of the survivors had tumor recurrence or metastasis during the follow-up period.The 1-year survival rate calculated by kaplan-meier method was 76.2%,and the 5-year survival rate was 42.9%.Conclusion:Pelvic Ⅰ and Ⅲ malignant bone tumor wide excision under the security boundary mechanical joint from body ipsilateral internal fixation after the reconstruction of the ilium or allograft bone transplantation method can make patients get satisfactory postoperative curative effect;Pelvic Ⅱ area of malignant bone tumors do after resection in the boundary of security choose relatively stable half pelvic prosthesis for functional reconstruction of the postoperative curative effect in the acceptable range.