Sacral and coccygeal tumor resection
Sacral and coccyx tumor resection is one of the surgical methods for radical or local resection of tumors occurring in sacral and coccyx bones. Treatment of diseases: fracture of the tailbone and dislocation of the bone tumor Indication Patients with sacral and coccyx tumors. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation Detailed medical history and physical examination, combined with X-ray imaging, often find the specific location of sacral and coccyx tumors. There are many blood loss during operation, and a large amount of blood should be imported. The same type of blood and plasma should be prepared before surgery. Surgical procedure Position preparation. In order to balance the intraoperative exposure of the tumor vessels (anterior) to remove the blood supply (posterior) of the sacral tumor. The patient was placed in the right lateral position with a soft pillow of 40 cm × 25 cm × 25 cm under the shoulder. The upper limbs were placed parallel on the support frame, and the lower limbs were not fixed. When disinfecting, first place the patient on the prone position, disinfect the back skin to the right midline, and place the sterile middle sheet on the lower scapula. Then the patient sterilizes the abdominal skin to the right anterior line, up to the nipple line, and sterilizes. In the single, re-sterilize the lower limbs and then use a sterile single-package. The patient should first tilt the soft pillow under the patient 10cm forward, so that the patient tilts 45 degrees in the supine position, anterior surgery, abdominal aorta block, and then Prepare the soft pillow and the body position. In order to balance the intraoperative exposure of the tumor vessels (anterior) to remove the blood supply (posterior) of the sacral tumor. The patient was placed in the right lateral position with a soft pillow of 40 cm × 25 cm × 25 cm under the shoulder. The upper limbs were placed parallel on the support frame, and the lower limbs were not fixed. When disinfecting, first place the patient on the prone position, disinfect the back skin to the right midline, and place the sterile middle sheet on the lower scapula. Then the patient sterilizes the abdominal skin to the right anterior line, up to the nipple line, and sterilizes. In the single, re-sterilize the lower limbs and then use a sterile single-package. The patient should first tilt the soft pillow under the patient 10cm forward, so that the patient tilts 45 degrees in the supine position, anterior surgery, abdominal aorta block, and then Move the soft pillow and the patient backwards by 20cm, so that the patient leans forward, takes the 45-degree prone position, and performs posterior surgery. This method of taking different postures according to different stages of the operation can make the surgical field clear and completely exposed. Also ensure that the surgical field is sterile. Preparation for anesthesia. All patients underwent sacral tumor surgery with systemic hypothermic anesthesia and controlled hypotension. After anesthesia, another radial artery puncture and subclavian vein puncture were performed to monitor the changes of mean arterial pressure and central venous pressure, which provided a reliable basis for maintaining blood pressure during operation. complication There were no major complications after surgery.
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