Complex limb-saving cancer surgery at KMC

Doctors of the Department of Surgical Oncology, Kasturba Medical College and Hospital, performed a complex limb saving cancer surgery on the pelvic bone of a 45-year-old woman here recently.

A press release issued by the Kasturba Hospital here on Monday said that the patient has recovered after six weeks of total rest and is walking comfortably after adequate physiotherapy.

The patient had a history of pain and swelling in the lower back. On evaluation, she was diagnosed to have tumour of Ilium (part of pelvic bone) involving right sacroiliac joint. The surgery (Internal Hemipelvectomy, Type IV resection) was planned after reserving adequate blood components.

The important part of the surgery was to identify and safeguard all major nerves and blood vessels that supply to the lower limb. The major steps of surgery included dividing the pelvic bone just above the hip joint after protecting the sciatic nerve, cutting the sacral bone lateral to sacral foramina after protecting lumbosacral trunk.

The tumour was removed en bloc along with sacroiliac joint. Mesh was placed to improve fibrosis and joint stabilisation. The skin defect was reconstructed by local flap. The surgery, which lasted 10 hours, was performed by Naveena Kumar A.N. He was assisted by Nawaz Usman, Sudhir Varma, Ananth S. Mathad from the Department of Surgical Oncology. The reconstruction was performed by Srikumar and Joseph from the Department of Plastic Surgery and anaesthesia was managed by Manjunath Prabu and Yogesh Gaude.

Surgery of this part of body is challenging because of complex anatomy. In this particular case, complete removal of tumour as well as saving the limb was a challenge as major blood vessels and nerves of lower limb travelled close to the large tumour. Any injury to these blood vessels may have caused major bleeding and could have been life-threatening. Any injury to nerves could have led to permanent weakness of the lower limb, the release said.

Avinash Shetty, Medical Superintendent, Kasturba Hospital, said, “This kind of limb saving supra-major surgery is performed only in a few centres in India. The Department of Surgical Oncology at Kasturba Hospital, Manipal, performs all major and supra-major cancer surgeries giving new hope to cancer patients in the region.”

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Printable version | Feb 25, 2020 5:54:49 AM |

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