[Pelvic limb-salvage surgery for malignant tumors: 30 years of progress in China]

Abstract

This article reviews the development and progress in the field of limb salvage treatment, surgical techniques, and function reconstruction of pelvic malignant tumors in China in the past 30 years. Based on the surgical classification of pelvic tumor resection in different parts, the development of surgical techniques and bone defect repair and reconstruction methods were described in detail. In recent years, in view of the worldwide problem of biological reconstruction after pelvic tumor resection, Chinese researchers have systematically proposed the repair and reconstruction methods and prosthesis design for bone defects after resection of different parts for the first time in the world. In addition, a systematic surgical classification (Beijing classification) was first proposed for the difficult situation of pelvic tumors involving the sacrum, as well as the corresponding surgical plan and repair and reconstruction methods. Through unremitting efforts, the limb salvage rate of pelvic malignant tumors in China has reached more than 80%, which has preserved limbs and restored walking function for the majority of patients, greatly reduced surgical complications, and achieved internationally remarkable results.

Keywords: Pelvic malignant tumors; functional reconstruction; limb-salvage surgery; surgical classification.

图 1

Anteroposterior and lateral X-ray films after pedicle screw and rod reconstruction surgery for iliac wing defect 经椎弓根及耻坐骨钉棒系统重建髂骨翼缺损术后正侧 位X线片

图 2

Design and application of three-dimensional printed iliac prosthesis for reconstruction after resection of the tumor 3D打印人工髂骨假体的设计和应用

图 3

Modular hemipelvic endoprosthesis 组配式人工半骨盆假体

图 4

Three-dimensional printed hemipelvic endoprosthesis (GPS Ⅱ type) 3D打印人工半骨盆假体（GPS Ⅱ型）

图 5

The first generation of “the hemipelvic endoprosthesis fixed through lumbosacral spine” 第一代“经腰椎固定人工半骨盆假体”

图 6

The second generation of “the hemipelvic endoprosthesis fixed through lumbosacral spine” 第二代“经腰椎固定人工半骨盆假体”

图 7

The third generation of “the hemipelvic endoprosthesis fixed through lumbosacral spine” 第三代“经腰椎固定人工半骨盆假体”（GPSⅢ型）a. 实物图；b. 术后X线片示该假体三角稳定原理

图 8

Putting-aside technique 旷置术

图 9

Recycled tumor-bone implantation 灭活再植术

图 10

Fusion surgery between femoral head and iliac bone 股骨与髂骨融合术后1年

图 11

Beijing classification Beijing 分型示意图

图 12

Types of resection and reconstruction based on Beijing classification 基于Beijing分型的切除范围及功能重建方法