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This book introduces the current state of surgical treatment in this particular location-sacrum and pelvis, presenting progress and innovation, describing in detail the related procedures. The book comprises three main parts, pelvic, sacral and typical cases. In each part, chapters are organized in a parallel fashion, with general considerations, surgical approaches and commonly used procedures. This helps to illustrate and detail the surgical techniques involved. This book is valuable for surgeons dealing with this challenging disease. Additionally, it summarizes and reinforces the previous knowledge of techniques in this field.
This book presents our experience in the operative treatment of bone and soft-tissue tumors arising in and around the pelvis, from 1970 to 1999 in the Department of Orthopedic Surgery at the Niigata University Medical Hospital. Histological diagnoses included both benign and malignant tumors. Surgical plan ning was difficult to perform in our early experience in operative treatment, when only angiography and barium enemas were in use. In the meantime, computed tomog raphy scanning and magnetic resonance imaging became available. Subsequent improvement in the quality of these images made three-dimensional surgical plan ning for pelvic tumor removal much easier. Such progress in diagnostic methodolo gies, together with advancements in microsurgical techniques, methods of irradiation, and various adjuvant chemotherapies has led to significant improvements in the treat ment of pelvic tumors. Furthermore, these advancements were enhanced by the avail ability of various conventional and custom-made endoprostheses, plates and screws, spinal instruments, and external fixators made of 3161 stainless steel, titanium, high density polyethylene, and ceramics. Because sacral tumors are so silent and symptomless, they may grow to a large size and be difficult to excise. Removal of sacral tumors might make subjective symptoms worse because the sacrum contains the cauda equina. Excision of a tumor that involves the ilium and sacroiliac joint may interrupt the structural stability of the pelvic ring. A tumor affecting the hip joint may require reconstruction to re-establish the func of the hip and to provide stability for gait after operative treatment.
Approaches to complex pelvic surgery have changed dramatically in recent years thanks to the development of the entire field of orthopedic surgery. This volume focuses on the mastery of diagnosis, management and operative techniques for tumors of the pelvis. It also provides a thorough understanding of how to select the best procedure, how to avoid complications, and what outcomes to expect. Written by experts from leading institutions around the globe, it is a comprehensive reference on treating the full range of musculoskeletal tumors frequently encountered in the pelvis. It offers an overview and an update on the epidemiology, principles of initial assessment, clinical presentation and imaging characteristics of pelvic tumors, guiding clinicians through key questions for developing a differential diagnosis and selecting the appropriate surgical technique. This book is an indispensable resource for orthopedists, oncologists, as well as radiologists and pathology specialists treating patients with bone and soft-tissue tumors.
An innovative guide to the practice of pelvic exenterative surgery for the management of advanced pelvic neoplasms Exenterative surgery plays an important role in the management of advanced pelvic cancer. However, while a large body of evidence regarding outcomes following pelvic exenteration now exists, practical strategies and management options remain unclear. Surgical Management of Advanced Pelvic Cancer addresses this problem by assembling world-leaders in the field to provide insights into the latest techniques and best practices. It includes detailed coverage of: Surgical anatomy Operative approaches and exenterative techniques Reconstruction options Current evidence on survival and quality of life outcomes Featuring essential information for those managing patients with advanced pelvic neoplasms, Surgical Management of Advanced Pelvic Cancer consolidates the latest data and practical advice in one indispensable guide.
This book provides an up-to-date overview on the epidemiology, clinical presentation, and imaging characteristics of sacral tumors, discusses the available treatment options, and reports the published outcomes. The diagnostic roles of conventional radiology, CT, and MRI are thoroughly described and imaging appearances are compared with the histologic features. The coverage of therapeutic approaches includes chemotherapy, radiotherapy, radiosurgery, and surgery (partial or total sacrectomy and spinopelvic reconstruction). Special attention is paid to the specific anatomic constraints that make tumors in this region of the spine more difficult to manage effectively than those in the extremities and the mobile portions of the spine. All components of the sacrum can give rise to benign or malignant tumors, which pose significant diagnostic and therapeutic challenges. Although these tumors are often diagnosed at an advanced stage, good clinical outcomes may be achieved if an aggressive multidisciplinary approach is used. This book will be of value for a range of practitioners; it will assist in prompt diagnosis and help to overcome lack of familiarity with the required treatment strategies.
This practical, step-wise text covers the surgical approaches, resection strategies and reconstruction techniques used for each type of presenting tumor of the spine. Demonstrating the variety of anterior, posterior and intradural approaches and stabilization techniques, and spanning from pathologies of the craniocervical region to sacral and intradural pathologies, each chapter is generously illustrated with figures, radiographs and intraoperative photos. The chapters themselves follow a consistent and user-friendly format: the anatomy and biomechanics of a specific region, patient evaluation, essential oncologic principles, the decision-making process, and technical steps of surgery. A representative case illustration is provided at the conclusion of each chapter, exemplifying pertinent concepts described. Additionally, video segments accompany selected chapters, providing real-time illustration of surgical techniques. Technical and in-depth, yet highly accessible, Spinal Tumor Surgery: A Case-Based Approach is an essential resource for orthopedic spine surgeons, neurosurgeons, and surgical oncologists operating on tumors of the spine.
Steven A. Rosenberg, MD In the past two decades significant progress has quality of life. The use of local radiation therapy has occurred, in the management of patients with mus- had a profound impact on the ability to achieve local loskeletal cancers, that has improved both the survival control. Cooperation between surgeons and radiation and the quality of life of afflicted patients. Changes in therapists often results in the tailoring of surgical p- the management of these patients have mirrored cedures to maximize the combined application of these trends in the entire field of oncology. two effective treatment modalities. Although impact on The most significant change has been improvement overall survival has not been demonstrated due to the in the surgical techniques for the resection of musculo- addition of radiation therapy, important advances in skeletal cancers based on a detailed understanding of improving the quality of life of patients receiving this the anatomic features of each particular tumor site, as combined-modality treatment have been evident. well as an appreciation of the natural biology that affects A third change impacting on the survival of patients the local spread of these tumors. The current volume of with musculoskeletal cancers has been the aggressive Musculoskeletal Cancer Surgery: Treatment of Sarcomas and resection of metastatic deposits.
This book reflects the experience of the Rizzoli Orthopedic Institute during more than 100 years of treatment of musculoskeletal tumor and tumorlike lesions. It presents a wide range of lesions from a multidisciplinary perspective, highlighting pertinent clinical, radiological, and histological correlations. Treatment is briefly reported for each entity. In addition, the more recent biomolecular findings of use for diagnosis, prognosis, and treatment are carefully analyzed. The Rizzoli case archive spans more than a century, the first treated case dating back to 28 September 1900, and contains the original material – clinical charts, imaging, paraffin blocks, and histological slides – of more than 40,000 cases, including about 29,000 bone lesions and 11,000 soft tissue lesions. This book reports the most relevant entities and reflects the improvements in knowledge of musculoskeletal tumors as presented during the yearly international course held at the Rizzoli Institute.​
The impetus for this book came from the recent appearance of single specialty books pertaining to reoperative surgery on various organs in the pelvis, as well as from the recognition that several different disciplines are involved with the challenges of reoperative pelvic surgery. Surgeons often encounter challenging dilemmas involving organ systems that have historically been attended to by surgeonsrepresentingcloselyrelatedbut distinctspecialtyareas. Withincreasing sophisticationand knowledge about management of anatomically adjacent organs by the specialties of gynecologic oncology, gynecology, urology, and colon and rectal surgery, as well as the emergence of specialty training programs in urogynecology and pelvic floor disorders, we thought it appropriate and timely to create a textbook acknowledging this increasing knowledge and interspecialty collaboration. To this end,where appropriate, we haveincluded collaborative authors fromeach of the specialties, any ofwhommaybecalledupontoaddressaparticularanatomicarea. Itseemsinevitablethatsituations willariseinwhichthecollaborativeexpertiseofseveralseparatespecialtiesmayconvergetoprovide surgeons the benefit of the combined thought processes that would prove invaluable when such difficult problems are encountered. With this in mind, the editors, from the fields of gynecologic oncology, urology, and colon and rectal surgery, identified experts in theirown fields who could bestcontribute to the management of specific problem areas. For example, since reoperations for endometriosis may involve uterus, adnexae, ovaries, or the colorectum, the chapter concerning this condition has been coauthored by specialists in colorectal surgery and gynecologic oncology. We have been fortunate to find experts who have collaborated to bring available evidence-based medicine, best demonstrated practices, and personal experience to their contributions.