Premium
Combined anterior‐posterior approach with enlarged sciatic foramen to remove sciatic notch dumbbell‐shaped tumors
Author(s) -
Li Mi,
Li Hao,
Du Yu,
Cai Zhuo,
Liao Hui,
Guo Fengjing,
Chen Anmin,
Li Feng,
Yang Caihong
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24552
Subject(s) - medicine , sciatic nerve , magnetic resonance imaging , foramen , dumbbell , dissection (medical) , anatomy , radiology , physical therapy
BACKGROUND AND OBJECTIVES To explore a new method for resecting huge sciatic notch dumbbell‐shaped tumors. METHODS Preoperative thin‐slide scanning magnetic resonance images (MRI) and computerized tomography angiography (CTA) scans were conducted. The images were processed to reconstruct a 3‐dimensional (3D) model. The relationship between the tumor and surrounding anatomical structures was accurately identified. By combining an anterior‐posterior approach, about 1.0 × 5.0 cm 2 c‐shaped bone around the greater sciatic foramen was removed using piezosurgery osteotomy to enlarge the sciatic notch, after which retroperitoneal dumbbell‐shaped tumors in the four patients were excised. RESULTS Tumors in four patients were completely removed. Two patients obtain a total en bloc tumor resection; one patient was clinically determined to be a benign nerve‐sheath tumor which was removed within the sciatic nerve sheath, and one patient had an extremely asymmetric tumor shape. The tumor unexpectedly split at the dumbbell isthmus across the greater sciatic foramen during blunt dissection, while both sections were completely removed. CONCLUSIONS The combined anterior‐posterior approach with an enlarged sciatic notch is an effective method to remove sciatic notch dumbbell‐shaped tumors. Compared to the reported study, it is a new method probably helpful for selected patients.