解放军医学院学报2024，Vol.45Issue(9)：931-936,6.DOI:10.12435/j.issn.2095-5227.2023.167
改良Ganz-髂腹股沟入路联合Lars韧带行软组织重建治疗骨盆Ⅱ区肿瘤的疗效研究
Clinical outcomes of modified Ganz-iliac inguinal approach combined with Lars ligament utilization for soft tissue reconstruction in treatment of pelvic region tumors in enneking Ⅱ
赵子仪 1赵雪林 2郭子轩 2朱庆岩 2李健雄 2王振 2王梓颖 2许猛2
作者信息
- 1. 解放军医学院,北京 100853
- 2. 解放军总医院第四医学中心骨科医学部骨肿瘤科,北京 100853
- 折叠
摘要
Abstract
Background The effectiveness of soft tissue reconstruction during pelvic tumor resection has not been systematically studied.Objective To analyze the clinical efficacy of using a modified Ganz-iliac trochanteric approach combined with Lars ligament and prosthesis for bone and soft tissue defect reconstruction in pelvic tumor resection.Methods A retrospective analysis was conducted on 35 patients with pelvic tumors in zoneⅡwho were treated at our hospital from February 2019 to January 2022.The patients were divided into two groups based on different surgical methods:one group underwent pelvic reconstruction using the modified Ganz-iliac trochanteric approach combined with Lars ligament and prosthesis,while the other group underwent traditional iliac trochanteric approach combined with prosthesis for pelvic reconstruction.Perioperative indicators,MSTS score,Harris score,VAS score at 12 months post-surgery,as well as imaging examinations to assess tumor recurrence and metastasis were recorded and compared between the two groups.Results In the modified surgery group,there were 10 males and 9 females with an average age of(38.42±19.89)years;16 cases had malignant tumors and 3 cases had benign tumors.In the traditional surgery group,there were 9 males and 7 females with an average age of(39.68±17.52)years;including 14 cases of malignant tumors and 2 cases of benign tumors.There was no statistically significant difference in general data between the two groups(P>0.05).Both groups completed hemipelvic prosthesis reconstruction according to preoperative plans,and no perioperative death occurred.Compared to the modified group,the traditional group had longer postoperative drainage time(7.57±0.80 days vs 10.06±1.08 days,P＜0.001),greater postoperative drainage volume(1519.84±280.57 mL vs 1711.25±266.07 mL,P=0.023),with statistically significant difference.At 12 months after surgery,MSTS score(23.18±1.34vs21.10±1.03,P=0.004)and Harris score(68.65±7.57vs64.17±6.94,P=0.04)of the modified group were significantly higher than those of the traditional group,and the differences were statistically significant.There were 2 cases of wound infection and 3 cases of deep infection in the traditional group,while no complications occurred in the modified group.The mean postoperative follow-up was 21.5±6.92 months,and there was no tumor recurrence.Conclusion The use of a modified Ganz-iliac trochanteric approach combined with Lars ligament can effectively protect pelvis stability during bone tumor resection in zone Ⅱregion of pelvis,recover patient's function after operation,and significantly reduce occurrence probability complications.关键词
骨盆肿瘤/Ganz入路/Lars韧带/骨与软组织重建Key words
pelvic tumor/Ganz approach/Lars ligament/bone and soft tissue reconstruction分类
医药卫生引用本文复制引用
赵子仪,赵雪林,郭子轩,朱庆岩,李健雄,王振,王梓颖,许猛..改良Ganz-髂腹股沟入路联合Lars韧带行软组织重建治疗骨盆Ⅱ区肿瘤的疗效研究[J].解放军医学院学报,2024,45(9):931-936,6.
