Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis
CPT4 code
Name of the Procedure:
Radical Resection of Tumor; Wing of Ilium, 1 Pubic or Ischial Ramus or Symphysis Pubis
Common Name: Radical bone tumor surgery in the pelvis
Summary
This procedure involves the surgical removal of a tumor located in specific areas of the pelvis, such as the wing of the ilium, one of the pubic or ischial rami, or the symphysis pubis. The aim is to completely excise the tumor and any associated tissues to prevent its spread.
Purpose
Condition Addressed:
The procedure is indicated for patients with malignant bone tumors affecting the pelvis.
Goals:
The primary goal is complete removal of the tumor, which can help in alleviating symptoms, preventing metastasis, and potentially curing the condition.
Indications
- Presence of a malignant bone tumor in the pelvis, confirmed through imaging and biopsy.
- Symptoms like persistent pain, functional impairment, or localized swelling.
- Specific patient factors such as overall health status and potential for recovery.
Preparation
- The patient may need to fast for several hours before the surgery.
- Preoperative imaging studies (e.g., MRI, CT scans) to define the extent of the tumor.
- Laboratory tests for blood counts, kidney and liver function.
- Consultation with an anesthesiologist for pre-anesthesia assessment.
- Adjustments to current medications as advised by the healthcare team.
Procedure Description
- Anesthesia: General anesthesia will be administered to ensure the patient is asleep and pain-free.
- Incision: A surgical incision is made over the affected area of the pelvis.
- Tumor Removal: Surgical instruments are used to carefully excise the tumor along with a margin of healthy tissue to ensure complete removal. Depending on the location, parts of the affected bone (wing of ilium, pubic or ischial ramus, symphysis pubis) are resected.
- Reconstruction: Reconstruction of the pelvic structure may involve using bone grafts or prosthetic implants.
- Closing: The incision is closed with sutures or staples, and a dressing is applied.
Duration
The procedure typically takes between 2 to 5 hours, depending on the size and location of the tumor.
Setting
This surgery is performed in a hospital operating room equipped for complex orthopedic surgeries.
Personnel
- Orthopedic surgeon specialized in oncology
- Surgical assistants
- Anesthesiologists
- Operating room nurses
Risks and Complications
Common Risks:
- Infection
- Bleeding
- Pain
Rare but Serious Complications:
- Damage to surrounding organs or nerves
- Blood clots
- Prosthetic implant failure
- Recurrence of the tumor
Benefits
- Complete tumor removal may provide pain relief and improve function.
- Reduces the risk of cancer spreading to other parts of the body.
- Improved quality of life post-recovery.
Recovery
- Post-Procedure Care: Pain management, antibiotics to prevent infection, physical therapy.
- Instructions: Rest and limited activity for several weeks; follow-up appointments for monitoring.
- Recovery Time: Varies but generally takes several weeks to months; specific restrictions on weight-bearing movements.
Alternatives
- Radiation therapy
- Chemotherapy
- Less radical surgical options, depending on the tumor's size and location.
- Non-surgical treatments like targeted therapy in specific cases.
- Pros and cons should be discussed with the healthcare provider considering factors like tumor type, treatment efficacy, side effects, and patient health.
Patient Experience
During the Procedure:
- The patient will be under general anesthesia and will not feel any pain. ##### After the Procedure:
- Postoperative pain management includes medications and comfort measures.
- Temporary discomfort from the incision site and mobility restrictions.
- Physical therapy will be integral to regain strength and function.