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Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

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Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

PelvisShervin V. Oskouei, David K. Monson, Albert J. AboulafiaChapter70CONTENTSIntroduction......Surgical Anatomy....Surgical ApplicationsIncisional B

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2Biopsy.4444444494S5Excisional Biopsy........................ 457Anterior Dissection...................... 459Posterior Dissection....................

46ÌReconstruction Following InternalHemipelvectomy..................... 478Anatomic Basis of Complications.... 478Key References..................... Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

479Suggested Readings................. 480w.c. Wood, J.E.Skandalakis, and c. A. Staley (Eds.): Anatomk Baiii of Tumor Surgery, 2nd Edition DOI: 978-3-

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

S40-74177-0JO, © Springer-Verbg Berlin Heidelberg 2010443444 Chapter w PelvisIntroductionIt is estimated that approximately 2,000 new cases of bone sa

PelvisShervin V. Oskouei, David K. Monson, Albert J. AboulafiaChapter70CONTENTSIntroduction......Surgical Anatomy....Surgical ApplicationsIncisional B

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2pelvis. Major advances in our understanding of sarcoma biology have led to advances in chemotherapy and surgical techniques that offer the patients wi

th nonmetastatic disease the potential for longterm disease-free survival and cure rates exceeding 50%. This is especially true for the two most commo Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

n bone sarcomas, osteosarcoma and Ewing’s sarcoma. In addition, advances in preoperativc imaging studies have allowed surgeons to define the anatomic

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

extent of disease more accurately, and thereby plan surgical procedures with curative intent more precisely. However, these rates of cure for malignan

PelvisShervin V. Oskouei, David K. Monson, Albert J. AboulafiaChapter70CONTENTSIntroduction......Surgical Anatomy....Surgical ApplicationsIncisional B

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2ing resection with wide margins very difficult.Until recently, hemipelvectomy was considered the standard surgical procedure for the management of pat

ients with pelvic sarcoma. The procedure, however, is disabling and sacrifices a viable extremity to achieve local tumor control. Predicated on an und Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

erstanding of sarcoma biology, surgeons have developed limb-sparing procedures that are intended to achieve local tumor control while maximizing funct

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

ion. New reconstructive procedures allow lor a complete or partial resection of the innominate bone, often termed internal hcmipclveclomy, with preser

PelvisShervin V. Oskouei, David K. Monson, Albert J. AboulafiaChapter70CONTENTSIntroduction......Surgical Anatomy....Surgical ApplicationsIncisional B

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2 bladder, or to simultaneously include bony resections involving the spine and/or the sacrum.Sarcomas grow in centrifugal fashion, forming a central c

ore. As they grow, they tend to compress the normal cells and form a pseudocapsule composed of compressed turner cells and a fibrovascular zone of rea Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

ctive tissue. This pseudocapsule gives the appearance of a well-encapsulated tumor. The pseudocapsule is surrounded by grossly normal-appearing tissue

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

that may have tumor cells within it, known as a satellite or micrometastalic lesion. These lesions are believed to Ik- the cause of local recurrence

PelvisShervin V. Oskouei, David K. Monson, Albert J. AboulafiaChapter70CONTENTSIntroduction......Surgical Anatomy....Surgical ApplicationsIncisional B

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2an Ik- planned, with the goal of maximizing function while at the same time obtaining local tumor control.Surgical AnatomyTopography The pelvis is the

region of the trunk below the abdomen and immediately above the lower extremities. The iliac crest can be felt along its entire length from the anter Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

ior superior iliac spine to the posterosuperior iliac spine. The pubic symphysis is in theSurgkal Anatomy 445midline anteriorly, near the distal inser

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

tion of the rectus abdominis muscles. The sacral spinous processes are posterior in the midline, within the upper portion of the gluteal cleft, and th

PelvisShervin V. Oskouei, David K. Monson, Albert J. AboulafiaChapter70CONTENTSIntroduction......Surgical Anatomy....Surgical ApplicationsIncisional B

Ebook Anatomic basis of tumor surgery (2nd edition): Part 2 the greater trochanter of the proximal femur.Each common iliac artery ends at the level of the sacral promontory in front of the Blood Supply sacroil

iac joint by dividing into the external and internal iliac arteries. The externalInternal use a. ana V.Anterior divisionCommon Iliac a. and v. Ebook Anatomic basis of tumor surgery (2nd edition): Part 2

PelvisShervin V. Oskouei, David K. Monson, Albert J. AboulafiaChapter70CONTENTSIntroduction......Surgical Anatomy....Surgical ApplicationsIncisional B

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