27076 Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum

Name of the Procedure:

Radical Resection of Tumor; Ilium, Including Acetabulum, Both Pubic Rami, or Ischium and Acetabulum

Summary

This procedure involves the surgical removal of a tumor located in the hip or pelvic bones. Specifically, it targets tumors in the ilium, acetabulum, both pubic rami, ischium, or acetabulum—key parts of the pelvic bone.

Purpose

The primary purpose is to excise cancerous or problematic tumors in the pelvic region, aiming to eradicate cancer and prevent its spread. The expected outcome is to achieve a tumor-free margin while preserving as much function as possible in the affected area.

Indications

• Presence of a malignant tumor in the pelvic bones.
• Severe pain or dysfunction in the hip or pelvic region due to the tumor.
• Failure of other treatments like radiation or chemotherapy to control tumor growth.

Preparation

• The patient may need to fast for 8-12 hours before surgery.
• Pre-surgical imaging tests like MRI or CT scans are required to determine the exact size and location of the tumor.
• Blood tests and other routine diagnostic assessments will be conducted.
• Patients should inform their doctor of all medications they are taking; some may need to be paused or adjusted.

Procedure Description

1. The patient is given general anesthesia to ensure they are fully unconscious and pain-free.
2. A surgical incision is made to access the tumor in the pelvic bone.
3. The surgeon carefully removes the tumor along with some surrounding healthy tissue to ensure clean margins.
4. Specialized tools such as scalpels, bone saws, and possibly electrocautery devices are used.
5. Reconstruction or stabilization of the pelvic bone may be necessary, possibly requiring bone grafts or metal hardware.
6. The incision is closed with sutures or staples.

Duration

The procedure typically takes between 3 to 6 hours, depending on the complexity and extent of the tumor.

Setting

This surgery is performed in a hospital operating room equipped for major orthopedic or oncological procedures.

Personnel

• Orthopedic or oncologic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists
• Potentially a plastic surgeon for reconstructive aspects

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve damage leading to weakness or numbness
• Fractures in the pelvic bone
• Bleeding or hematoma formation
• Possibility of tumor recurrence

Benefits

• Complete removal of cancerous or problematic tissue
• Relief from pain and other symptoms
• Reduced risk of cancer spreading to other areas

Recovery

• Patients usually stay in the hospital for 5 to 10 days post-surgery.
• Physical therapy is often required to regain mobility and strength.
• Full recovery can take several months, with limitations on heavy lifting and vigorous activities.
• Regular follow-up appointments are essential to monitor healing and check for cancer recurrence.

Alternatives

• Radiation therapy: Useful for shrinking the tumor, but may not be curative for large or aggressive tumors.
• Chemotherapy: Often used in combination with other treatments but may not be effective alone.
• Less radical surgical options: May be considered if the tumor is small and localized, but might not fully eradicate the disease.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel anything. Post-surgery, they might experience pain and fatigue, managed with medications. The initial weeks involve significant pain management and limited mobility, gradually improving with physical therapy and proper care.