Preoperative angiography and embolization of large pelvic tumors.
OBJECTIVE
Pelvic tumors are often large and difficult to excise with appropriate surgical margins due to their size, proximity to neurovascular structures, and major intraoperative bleeding. The purpose of this study is to evaluate the yield of preoperative angiography and embolization so as to facilitate achievement of good surgical results.


METHODS
Eighteen patients who suffered from large pelvic tumors (average size, 10.7 cm x 8.3 cm x 3.7 cm), 15 primary and 3 metastatic, underwent surgery at our institution between 1990 and 1995, after preoperative angiography and embolization of the tumors.


RESULTS
The efficacy of the procedure was high. In all but one patient, the grade of vascularity of the tumor was reduced by at least two levels (based on our new tumor vascularity scale. In most patients, appropriate surgical margins were achieved. The average perioperative blood loss was only 750 cc. Procedure-associated complications were negligible.


CONCLUSIONS
The results of this study call for the use of angiography and embolization in the management of patients with large pelvic tumors.
Salai
M
M
Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel. henigman@post.tau.ac.il
Garniek
A
A
Rubinstein
Z
Z
Segal
A
A
Morag
B
B
D000792:Angiography; D004621:Embolization, Therapeutic; D006801:Humans; D010386:Pelvic Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed