Radical resection of tumor; innominate bone, total
CPT4 code
Name of the Procedure:
Radical Resection of Tumor; Innominate Bone, Total
Common name(s): Complete pelvic bone tumor removal, Innominate bone resection
Summary
Radical resection of a tumor in the innominate bone involves surgically removing the entire pelvic bone to eliminate cancerous cells. The procedure aims to excise the tumor entirely to prevent spreading and may include subsequent reconstructive surgery.
Purpose
The primary purpose of this surgery is to treat malignant tumors located in the innominate bone (part of the pelvis). It aims to remove all cancerous tissue to prevent metastasis and recurrence, improving long-term survival and quality of life.
Indications
- Presence of malignant tumors in the innominate bone (e.g., sarcomas).
- Failure of other treatments (e.g., chemotherapy, radiation).
- Severe pain or functional impairment due to the tumor.
- Rapidly growing tumors that threaten other pelvic structures.
Preparation
- Fasting for at least 12 hours before surgery.
- Adjustment of medications as advised by the doctor.
- Preoperative imaging studies (e.g., MRI, CT scans) to assess tumor size and location.
- Blood tests and possibly a bone biopsy.
- Pre-surgical physical examination and consent form signing.
Procedure Description
- Anesthesia: Patient is placed under general anesthesia.
- Incision: A large incision is made over the pelvis.
- Resection: The tumor, along with the innominate bone, is carefully removed. Surrounding tissues are checked for cancerous cells.
- Reconstruction: Reconstructive surgery may be needed to maintain pelvic stability, using prosthetics or bone grafts.
- Closure: The incision is closed with sutures or staples, and a drain may be placed to remove excess fluids.
Duration
The procedure typically takes 4-8 hours, depending on the complexity and extent of reconstruction required.
Setting
The surgery is performed in a hospital operating room equipped for major orthopedic and oncologic procedures.
Personnel
- Lead Surgeon (Orthopedic Oncologist)
- Surgical Assistants
- Anesthesiologist
- Scrub Nurses
- Circulating Nurses
- Radiologists (for intraoperative imaging, if needed)
Risks and Complications
- Common: Infection, bleeding, blood clots.
- Rare: Nerve damage, blood vessel injury, issues with wound healing, prosthetic complications.
- Long-term: Potential for tumor recurrence, impact on mobility and function.
Benefits
- Complete removal of cancerous tissue with potential cure.
- Relief from pain and other tumor-related symptoms.
- Prevention of tumor spread, improving life expectancy.
Recovery
- Hospital stay of 1-2 weeks post-surgery.
- Pain management with medications.
- Physical rehabilitation and possibly the use of mobility aids.
- Follow-up appointments for wound care and monitoring progress.
- Full recovery may take several months, with activity restrictions as needed.
Alternatives
- Chemotherapy: Can slow tumor growth but often insufficient alone.
- Radiation Therapy: Offers palliative relief but limited curative potential.
- Partial Resection: Less invasive but might not remove all cancer cells, leading to recurrence.
- Palliative Care: Focuses on quality of life without curative intent.
Patient Experience
- Postoperative pain, managed by analgesics.
- Initial immobility and need for support with daily activities.
- Gradual increase in mobility with the help of physiotherapists.
- Emotional support and counseling may be beneficial for coping.