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 zone Ⅱ who 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 ± 1.34 vs 21.10 ± 1.03, P=0.004) and Harris score (68.65 ± 7.57 vs 64.17 ± 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 Ⅱ region of pelvis, recover patient's function after operation, and significantly reduce occurrence probability complications.
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