Table 2 Advantages and limitations of the pararectus approach compared to established approaches in pelvic tumor surgery
From: The pararectus approach—a versatile option in pelvic musculoskeletal tumor surgery
Indications | Advantages | Limitations | |
|---|---|---|---|
Pararectus approach | Pelvic bone and soft tissue tumors | • Avoids extensive soft tissue flaps prone to wound healing problems • Uncomplicated medial, proximal and distal extension • Facilitates addressing periacetabular bone tumors, especially when intrapelvic soft tissue expansion is present • Good control of intra- and extrapelvic neurovascular structures | • Limited exposure in obese patients and cases with bowel obstruction • Mobilization of large tumors restricted due to avoidance of soft tissue flaps |
Pelvic bone tumors | • Wide exposure of the entire osseous pelvis through creation of soft tissue flaps •Wide exposure facilitates mobilization of large tumors and reconstruction of osseous pelvis | • Increased risk of wound healing disorders due to T-shaped skin incision and soft tissue flaps • Limited exposure of intrapelvic neurovascular structures, especially in cases with large soft tissue masses (exposure through ilioinguinal window) | |
Pelvic bone and soft tissue tumors | • Wide exposure of intrapelvic organs through creation of soft tissue flaps • Uncomplicated proximal and distal extension • Facilitates addressing periacetabular bone tumors, especially when intrapelvic soft tissue expansion is present • Good control of intra- and extrapelvic neurovascular structures | • Increased risk of wound healing disorders due to (double) L-shaped skin incision and soft tissue flaps • Entering peritoneal cavity disturbs a natural barrier against tumor dissemination and is associated with an increased risk of intraabdominal adhesions |