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[目的]有相当比例的原发或继发恶性骨肿瘤发生在骨盆部位,目前常用的外科治疗方法是荷瘤盆骨的切除及恢复骨盆连续性的重建。该手术创伤大,局部复发率高,术后功能差,是骨科医生公认的极具挑战性的难题。[方法]本文介绍一种全新的外科术式:将荷瘤盆骨从正常组织中分离,将微波天线均匀地插入瘤块内,输入电磁能量,通过热凝固达到杀灭瘤细胞的目的,勿需特殊的重建措施(不包括植骨等加固措施)。[结果]从1994年5月到2005年12月,152例骨盆恶性肿瘤患者接受了上述疗法,IB期病人中48例得到良好的局部和全身控制,61例IIB期患者,19例死于肿瘤播散,42例经过术后3～11年的观察,未发生远隔转移或局部复发,24例骨盆转移癌患者,11例于术后6个月～3年内死亡,13例病人在观察期1～7年内尚存活,无肿瘤存在迹象。在存活病人中,多数获得美容学和功能学上均可接受的肢体。[结论]该方法被证明为一种行之有效的途径,极大地简化了手术,改进了肿瘤学预后,明显改善了患肢的功能。
[Objective] A considerable proportion of primary or secondary malignant bone tumors occur in the pelvic region. Currently the most common surgical methods are resection of pelvic tumor and restoration of pelvic continuity. The surgical trauma, local recurrence rate, poor postoperative function, orthopedics recognized as challenging challenges. [Method] This article describes a new surgical technique: separating the tumor-bearing pelvis from the normal tissue, inserting the microwave antenna uniformly into the tumor mass, inputting electromagnetic energy and achieving the goal of killing tumor cells by thermal coagulation Need special reconstruction measures (excluding bone reinforcement and other measures). [Results] From May 1994 to December 2005, 152 patients with pelvic malignancies underwent the above-mentioned regimen. Forty-eight patients in stage IB had good local and systemic control, and 61 patients with stage IIB disease and 19 patients died of tumor Disseminated, 42 cases of postoperative 3 to 11 years of observation, no distant metastasis or local recurrence, 24 patients with pelvic metastases, 11 patients died within 6 months to 3 years after operation, 13 patients in the observation period 1 to 7 years still alive, no signs of tumor presence. Most of the surviving patients receive aesthetically and functionally acceptable limbs. [Conclusion] This method has proved to be an effective way to greatly simplify the operation, improve oncology prognosis, and obviously improve the function of limbs.