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PubMedDate not supplied

Partial or total hemipelvectomy in the management of sarcomas in nine dogs and two cats.

The functional results of partial or total hemipelvectomy in seven dogs and two cats with sarcomas involving the pelvis were excellent, and the cosmetic outcome was acceptable to all owners. Tumors in two dogs were inoperable. Locally recurrent cancer occurred in two animals and metastases occurred in three animals. Three dogs survived longer than 2.5 years and the overall and disease-free survival at 12 months was 62%. It appears that osteosarcoma of the pelvis is at least as aggressive as osteosarcoma of limbs and, unless effective adjuvant therapy is used, poorer survival results are likely in dogs with osteosarcoma than with other sarcomas of the pelvis. Hemipelvectomy is an aggressive surgical procedure that can be used successfully in selected dogs and cats with cancer involving the pelvis.

Animals↗
PubMed2003

Pregnancy after limb-sparing hemipelvectomy for Ewing's sarcoma. A case report and review of the literature.

Ewing's sarcoma of the bone is a malignant bone tumor occurring mostly in adolescence and was considered to have poor prognosis. With recent advances in multi-agent combined chemotherapy, prognosis has improved, and more patients with primary lesions in the pelvis opt for limb-saving surgeries. In the present case, Ewing's sarcoma in the left pelvis was diagnosed at the age of 11 and the patient underwent multi-agent chemotherapy combined with limb-sparing hemipelvectomy. She became pregnant at the age of 22. After an uneventful pregnancy, she delivered a healthy child at 37 weeks of gestation by cesarean section because of pelvic distortion. This is the first reported case of pregnancy and delivery after limb-sparing hemipelvectomy due to Ewing's sarcoma. Since the multi-modality treatment improves survival, the number of women with Ewing's sarcoma who desire pregnancy is expected to increase in the future. This is a valuable case that will provide useful information for such patients.

Adult↗
PubMed1977

Bladder function after hemipelvectomy.

Bladder function was studied in seven patients, 5 to 90 months after hemipelvectomy. The urological investigation comprised i.v. urography, micturition-cysto-urethrography, cystoscopy, cystometry and urodynamic investigations in terms of simultaneous flow and pressure measurements. Hemipelvectomy was found not to give rise to disturbances in micturition.

Adolescent↗
PubMed1999

Traumatic hemipelvectomy before body image has developed.

Traumatic hemipelvectomy is rarely observed because very few patients have survived from the initial trauma. We describe one male child who survived from this massive trauma with a good functional outcome. The boy was 28 months old when he was accidentally struck by a truck. He had severe open trauma of the pelvis and hemorrhage of the left lower limb. Amputation of the left hemipelvis, colostomy, cystostomy and removal of the left avulsed testicle were performed. Once healing had been achieved, he was transferred to our Department of Physical Medicine and Rehabilitation and rehabilitative management was begun, including prosthetic measurement and psychologic intervention for the patient and his parents. For 13 years of long-term follow-up, his prosthesis was readjusted annually. Now he is a 16-year-old middle school student. He is functioning remarkably well with a prosthesis. The psychologic report shows that he is emotionally stable and has good scholastic performance. Although hemipelvectomy appears to be a radical procedure in children, the potential for rehabilitation in a group of children before body image has developed appears to be unexpectedly good.

Adolescent↗
PubMed2004

Hemipelvectomy: a changing perspective for a rare procedure.

OBJECTIVE: To compare the prognosis of patients undergoing a hemipelvectomy (HP) in the treatment of pelvic sarcomas and carcinomas and to review the morbidity and mortality associated with HP. DESIGN: Retrospective chart review. SETTING: The Foothills Hospital, University of Calgary, Calgary, Alberta. PATIENTS: Thirteen patients with clinically and radiographically isolated malignancies involving the bony pelvis and adjacent structures. INTERVENTIONS: Patients were treated with either an external HP (9 patients) or internal HP (4) in 1983-2001. OUTCOME MEASURES: Survival and recurrence rates for patients in 2 histopathologic groups (sarcoma v. carcinoma); morbidity and mortality associated with HP. RESULTS: Hemipelvectomy was performed for 7 sarcomas (4 primary bone and 3 soft tissue) and 6 carcinomas (5 genital tract and 1 unknown primary). Seven of the 9 external HPs involved composite resection of other pelvic structures, including other pelvic viscera (3 patients), sacrum (3) and portions of lumbar vertebrae and nerves (1). There were no additional resections among the 4 internal HPs, but 3 patients had allograft reconstruction. Length of stay averaged 30 days (range 14-70 d). At least 1 complication occurred in 10 of 13 cases. The most common complication was flap necrosis occurring in 5 patients (38%). There was 1 perioperative death (8%). The survival of patients treated for sarcomas was better than for carcinomas, which were primarily of the genital tract. Only 1 of the patients with a pelvic sarcoma died of disease (86% disease-specific survival), with a median follow-up of 12 months (range 9-108 mo). Of the 7 sarcoma patients 5 were disease-free at last follow-up. One of 6 pelvic carcinoma patients died perioperatively, with another dying of unknown causes 4 months after surgery. Of the 4 remaining patients 3 died of disease, resulting in a median survival of 9 months (range 4-20 mo). Four of 6 patients with pelvic carcinomas developed recurrent disease, none local. CONCLUSIONS: HP has considerable morbidity but is a viable and potentially curative treatment for patients with pelvic sarcomas. With pelvic carcinomas HP was not curative, but did provide short-term local disease control. Future improvements in imaging techniques and quality-of-life studies may help with patient selection. The role of HP in recurrent carcinoma remains to be determined.

Adolescent↗
PubMed1976

A new technique for hemipelvectomy.

A new technique for hemipelvectomy has been developed in which a large anterior well vascularized flap is used. The preservation of an anterior flap is essential if the posterior flap cannot be preserved because of tumor involvement. The vascularized anterior flap may be superior to the posterior flap because of less dermal necrosis. Use of the anterior flap may increase the ease of hemipelvectomy and reduce blood loss at operation.

Adult↗
PubMed1983

Sling support during pregnancy after hemipelvectomy: case report.

A 32-year-old woman delivered a normal male infant by the vertex 14 years after hemipelvectomy. During pregnancy she remained ambulatory with forearm crutches and wore a specially designed sling that she felt provided support and comfort. It is suggested that such external support to the uterus of the pregnant woman after hemipelvectomy may enhance presentation by the vertex.

Adult↗
PubMed1983

Traumatic hemipelvectomy: report of two survivors and review.

Two surviving patients with traumatic hemipelvectomy are presented. Rapid transport, aggressive initial resuscitation, and attention to detail in the rehabilitation phase are necessary for the successful management of these patients. The viability of the psoas muscle should be assessed, because of the high possibility of avulsion. Associated nerve injury and complicating meningitis can be serious problems in the management of such patients. There is need to include this entity in the existing classifications of pelvic fractures. Hemipelvectomy is proposed as an alternative in the management of the severe unilateral open pelvic fracture with uncontrollable bleeding.

Accidents, Traffic↗
PubMed1994

Traumatic hemipelvectomy: a survivable injury.

Traumatic injury remains an unfortunate and all-too-common event in the United States military population. Traumatic hemipelvectomy is a rare but devastating injury with few survivors recorded in the medical literature. We report a surviving case of traumatic hemipelvectomy and review an approach to management.

Adult↗
PubMed1977

Long term survival after compound hemipelvectomy.

Three patients survived free of disease ten and one-half, ten and almost six years, respectively, following compound hemipelvectomy for a variety of tumors. Each patient had been operated upon previously at least three times, but the tumors were still well localized despite the propensity for local infiltration or growth. In addition to the lower extremity and the ipsilateral pelvic bones, varieties of organs were resected. In one patient with chondrosarcoma of the pelvis, there was a local recurrent mass and, in another with adenocarcinoma of the appendix, a solitary pulmonary metastasis. Both of these lesions were successfully resected, and the patients remained free of disease nine and four and one-half years, respectively, after resection of the recurrent lesions. The third patients had carcinoma of the penis with metastases in both groins; carcinoma of the breast devedeveloped nine and one-half years after hemipelvectomy. The two younger patients were fitted with prostheses, and all three adjusted fairly well physically and psychologically to their disability. Frequently, the huge size of these tumors, the infiltration of many contiguous structures and, possibly, other features known to be associated with a bad prognosis make them appear to be incurable. We suggest that slowly growing tumor which remain localized for a long time can be controlled if adequately excised, possibly because they may be associated with strong systemic immunity. The extremely few such patients who may be encountered in surgical practice ought, therefore, to be recognized as potentially curable and treated accordingly, despite the often formidable risk or technical problems at operation and the resultant postoperative disabilities.

Adult↗
PubMed1996

[Hemipelvectomy due to blast injuries: possibilities of occupational rehabilitation].

A case of traumatic hemipelvectomy due to explosion of an antitank shell in a 21-year-old Croatian Army soldier is described. Explosion was due to inadvertent handling of the shell in the army barracks. Literature data on persons who survived traumatic hemipelvectomy are extremely scarce; the injury is characterized by a very high death rate (60-100%). After prompt surgical treatment the patient developed a postoperative anaerobic clostridial infection. Owing to intensive clinical and physical therapy the patient was enabled for moving around in a special wheel-chair and walking with the help of crutches and a prosthesis. He was also enrolled in a training course in computer use. Continual physical therapy and psychotherapy were essential because of a high degree of disablement. Making the patient self-sufficient, fit for work and finding him an appropriate job is considered to be the responsibility not only of the professional medical team but also of joint efforts on the part of competent state ministries, Ministry of Defence, Ministry of Labour and Social Welfare, State Pension and Insurance Fund and Ministry of Education, Culture and Sports.

Adult↗
PubMed1988

Bony and soft tissue reconstruction and rehabilitation following traumatic hemipelvectomy, exsanguination and cardiac arrest.

Survival following traumatic hemipelvectomy in the child with subsequent local flap coverage of wounds has been previously described. The use of axial skin flaps and thigh and rectus abdominis musculocutaneous flaps for coverage of hemipelvectomy defects following tumor extirpation has also been noted in the literature. The use of muscle flaps to salvage otherwise nonvital bone and to eradicate osteomyelitis with subsequent wound closure has also been thoroughly demonstrated both clinically and experimentally. The use of musculocutaneous flaps to revascularize otherwise nonviable bone of the pelvis and thus maintain the pelvic girdle integrity, however, has not to our knowledge been previously reported. We recently had an opportunity to treat such a case, which we herein describe.

Amputation, Traumatic↗
PubMed1991

Traumatic hemipelvectomy.

Traumatic hemipelvectomy is an uncommon and devastating injury with few patients alive when they reach the hospital. There are only 19 reported survivors of this injury. This group includes 17 males and 2 females. All had severe, associated injuries. The mechanism of injury involved motorcycle, automobile, pedestrian/motor vehicle, or heavy machinery accidents. All surviving patients are young (10-34 years of age). Most suffered from a variety of postoperative complications. Two interesting patients with traumatic hemipelvectomy are reported. One involves a new mechanism of injury, the propellor of a motorboat. The management of these 2 patients is explained, the experience of others with similar injuries is reviewed, and the benefit of reconstruction with the gluteus myocutaneous flap is discussed.

Adult↗
PubMed1987

Traumatic hemipelvectomy.

Management of patients who have suffered traumatic hemipelvectomy is one of the most difficult challenges to confront a trauma surgeon. We present a case of a female survivor of traumatic hemipelvectomy and factors in the care of these patients that can lead to a successful outcome.

Accidents, Traffic↗
PubMed1994

Traumatic hemipelvectomy associated with contralateral hip dislocation: case report.

A case of a 28-year-old man surviving traumatic hemipelvectomy is presented. This patient is the first reported survivor in Australia of traumatic hemipelvectomy and one of few survivors reported in the world literature. Accurate and rapid early management including good resuscitation, rapid transport to the operating room and an aggressive team surgical approach all contributed to survival. Acute complications can be kept to a minimum by adhering to the approach of rapid resuscitation and early intervention by a team of surgeons. Associated dislocation of the contralateral hip with sciatic nerve damage and subsequent heterotopic calcification has not been previously reported and presents a significant obstacle to rehabilitation. Early attention to the psychological status of the patient and early involvement of rehabilitation specialists is advocated.

Accidents, Traffic↗
PubMed1975

Traumatic hemipelvectomy: case report and literature review.

A case of traumatic hemipelvectomy with survival is presented, apparently the sixth reported case in the literature. Following complete left hemipelvectomy and fracture of the right acetabulum, the patient recovered, demonstrated voluntary bowel and urinary control, was full weight bearing on crutches (against advice), and refused a bucket seat or prosthesis, as well as neurosurgical consultation. The patient was then unfortunately lost to followup.

Acetabulum↗
PubMed1977

Traumatic hemipelvectomy: a case report.

Traumatic hemipelvectomy is a devasting injury which few patients survive. A survivor of traumatic hemipelvectomy is described. Immediate and long-term management include prompt resuscitation, vascular control, urinary and fecal diversion, wound debridement, wound closure, and physical and psychologic rehabilitation.

Adult↗
PubMed1979

Locomotion of the hemipelvectomy amputee.

A locomotion study was performed on a hemipelvectomy amputee wearing a prosthesis. The experimental arrangement described in this paper, combining joint motion developed during walking, a computer analysis of the force pattern between the foot and ground and plotting of pressure point on the foot print, has enabled detailed investigation with demonstration of several abnormal features in the prosthetic gait of a hemipelvectomy amputee.

Adult↗