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At least 73 records · Page 4Linked to original sources
PubMed2000

Internal hemipelvectomy for solitary pelvic thyroid cancer metastases.

BACKGROUND AND OBJECTIVES: Radioactive iodine (RAI) therapy remains a primary treatment modality for metastatic thyroid carcinoma, but poor tumor uptake of the agent can limit its usefulness. While offering effective palliation, radiation therapy is not curative, and chemotherapy is even less useful. Surgical resection occasionally remains the only hope of offering a long-term cure in the case of isolated metastases. METHODS: We describe 3 cases of thyroid cancer metastatic to the pelvic girdle that were unresponsive to RAI and other nonoperative therapies, which presented over a 15-year time period. The pelvic disease was the only site of active disease in all cases, and all 3 patients were suffering considerable pain. All 3 patients underwent internal hemipelvectomy with reconstruction in 2 cases using a pelvic bone allograft. RESULTS: All 3 experienced symptomatic relief and early mobilization. While the infection rate was 100%, these all responded completely to operative debridement, irrigation, and antibiotics. One patient, found postoperatively to have a positive surgical margin, developed a local recurrence at 4 months and died. A second patient developed a local recurrence at 11 months and died. The third patient underwent a revision of her hip arthroplasty because of acetabular loosening after a fall 21 months postoperatively. She is alive, disease-free, and ambulatory with the aid of a cane 32 months after the original procedure. CONCLUSIONS: We propose this surgical procedure in selected patients with metastatic pelvic thyroid cancer. It provides symptomatic relief with a chance for prolonged disease-free survival some patients.

Acetabulum↗
PubMed1997

Internal hemipelvectomy in the treatment of recurrent carcinoma of the colon: report of a case.

PURPOSE: Although extended surgery has been established as an effective method for the treatment of advanced carcinoma of the colon, there are no reports in the literature of en bloc resection of the tumor together with the iliac bone. We report herein a 46-year-old woman with a second local recurrence after right colectomy, with the main objective of showing the possibility of indicating this type of surgery in selected cases. METHODS: In view of the lack of therapeutic options for the case and the absence of metastases, extended curative surgery for recurrent carcinoma of the colon was performed, with en bloc resection of the right iliac bone and of the crural nerve (Type I internal hemipelvectomy). RESULTS: After a 27-month follow-up, the patient is asymptomatic, with no signs of local recurrence or metastases. CONCLUSIONS: In selected cases, recurrent carcinoma of the colon can be treated by extended and aggressive surgery, including bone resection, to obtain an appropriate safety margins.

Adenocarcinoma↗
PubMed1984

[Traumatic hemipelvectomy--report of 2 cases].

Report and progress of 2 traumatic hemipelvectomies in motor-cyclists with excluding extraperitoneal tearing of half of the pelvis and disrupture of the pelvic vessels. No intraperitoneal injuries, no hurt of the equilateral kidney or the urinary tract; one with complete anal incontinence because of disrupture of the perineal muscles, one case without permanent anal insufficiency. Especially preposition in motor cyclists high velocity and excluding direct influence of power to the concerning pelvic side and the corresponding lower extremity.

Accidents, Traffic↗
PubMed2002

Internal hemipelvectomy and reconstruction with a megaprosthesis.

We treated nine consecutive patients by internal hemipelvectomy and reconstruction with custom-made megaprosthesis between 1990 and 1997. Four had a primary malignant bone or soft tissue tumour, one a recurrent benign giant cell tumour, three solitary metastatic bony lesions, and one a pelvic defect secondary to multiple revision procedures after total hip replacement. After a mean follow-up period of 62 (40-102) months five patients were still alive, including four of the eight patients with tumours. Three patients died as a result of the malignant disease, and one died of an infection related to the surgical treatment after 10-41 months. In two patients removal of the prosthesis was required due to infection, and six patients suffered various complications. One patient had an excellent outcome.

Adolescent↗
PubMed1985

Femoral artery based myocutaneous flap for hemipelvectomy closure: amputation after failed limb-sparing surgery and radiotherapy.

In this report, we have presented the first patient treated with a discontinuous myocutaneous flap for coverage of a hemipelvectomy combined with buttockectomy. This procedure allows circumferential excision of all tissues anterior and posterior to the hemipelvis. The circular defect that extends from the anus to anterior abdominal wall is covered with fresh tissue obtained from the anterior thigh just above the knee and supported on the superficial femoral artery. The major principles to be emphasized are the use of uninvolved tissues, as well as obtaining adequate tumor-free margins.

Amputation, Surgical↗
PubMed2004

Emergency hemipelvectomy as a result of uncontrolled infection after total hip arthroplasty: two case reports.

Described are 2 patients with sepsis caused by an infection of a total hip arthroplasty. In both cases, the infection involved spread to the ipsilateral retroperitonial and proximal femur soft tissues, and substantial parts of the osseous hemipelvis and proximal femur. Furthermore, the infection could not be controlled despite repeated surgical interventions. Progression of the infection of soft tissue and bone resulted in severe bone stock loss, contractures of hip and knee, and severe neurologic deficit of the involved limb. Hemipelvectomy was indicated as a life-saving procedure. Reluctance to perform vigorous debridement, including removal of the components, can lead to a local spread of the infection, resulting in an uncontrollable process leading to a life-threatening situation.

Aged↗
PubMed2006

Total hip arthroplasty in a patient with contralateral hemipelvectomy.

Total hip arthroplasty has evolved in regard to surgical technique, implant design, and long-term survivorship over the last several decades with excellent clinical results. Owing to these improvements, indications for surgery have expanded to include a greater variety of patients. We present the case of a 62-year-old man who underwent total hip arthroplasty 39 years after contralateral hemipelvectomy. The importance of an appropriate preoperative plan in regard to patient positioning and postoperative protocol is addressed. Our patient was informed that data concerning his case would be submitted for publication.

Arthroplasty, Replacement, Hip↗
PubMed1995

Medial thigh myocutaneous flap for covering extended hemipelvectomy.

When a large tumour involves the buttock and anterolateral upper thigh, modifications to the classical hemipelvectomy may be required for its removal. Herein, we report the use of a medial myocutaneous flap for coverage of soft tissue defects produced by such procedures.

Adult↗
PubMedDate not supplied

[Complete dislocation of the polyethylene inlay after internal hemipelvectomy and individually fitted tumor endoprosthesis].

We report about an exceptional complication after internal hemipelvectomy and replacement of the defect with a custom-made endoprosthesis. A complete luxation of the PE-inlay out of the metal cup occurred. Radiologically we assumed a luxation of the femoral head in dorsal direction. Revision after a failed attempt of closed reposition showed a complete luxation of the inlay, which was caused by deficient fixation in the acetabular component. The absence of a contrast wire in the PE-inlay delayed the right diagnosis and made it difficult to find the dislocated inlay in the large wound.

Bone Neoplasms↗
PubMedDate not supplied

A patient with an electrical burn treated by modified bilateral hemipelvectomy and disarticulation of the right arm.

A 23-year-old Hispanic worker sustained an electrical injury to 45% of his body when a crane hit a power line. Amputations of both legs, with bilateral partial hemipelvectomies, were required. A disarticulation of the right arm at the shoulder was also preformed. Resection of necrotic bowel, debridement of 95% of the abdominal wall, and resection of the genitalia was eventually required, with later reconstruction of the abdominal wall. After wound healing was complete, the patient was fitted with Jobst garments. A customized bucket prosthesis with a temperature control, to allow sitting upright, was provided. An electric wheel chair and a myoelectronic prosthetic arm were supplied. Rehabilitation was begun early.

Abdominal Muscles↗
PubMed1984

Hemipelvectomy for liposarcoma: an unusual case and course.

A patient with liposarcoma of the upper thigh and pelvis treated by hemipelvectomy is described. Preoperative treatment with radiotherapy and chemotherapy induced regression and necrosis of the growth. The treatment of this tumour is discussed as well as the possibility that the pre-operative therapy converted an inoperable tumour into an operable one.

Amputation, Surgical↗
PubMed1989

Traumatic hemipelvectomy.

Traumatic hemipelvectomy is rare, and is usually accompanied by injury to the genito-urinary tract and bowel. Recently, there have been an increasing number of reports of patients who have survived this injury, probably as a result of improved early care. We report three such cases and review the literature. The amputation wound should not be closed initially; early re-exploration to remove any dead tissue is indicated, and this should be repeated as necessary.

Adult↗
PubMedDate not supplied

Chondrosarcoma secondary to hereditary multiple exostosis treated by extended internal hemipelvectomy.

The authors report on the case of a 28-year-old patient with extensive chondrosarcoma of the left ischium and pubis involving hip joint, skin, and soft tissue of the gluteal region, secondary to hereditary multiple exostosis submitted to an extended internal Enneking type II and III hemipelvectomy. No prosthesis or arthrodesis was used. A few years ago, patients with extensive tumors like this one were treated with interilioabdominal amputation, resulting in a loss of quality of life. Two years after the limb-preserving surgery, this patient was disease free, with good functional results, including bipedal ambulation with support.

Adult↗
PubMed1978

Hemipelvectomy. Postoperative rehabilitation assessed on the basis of 41 cases.

Rehabilitation was evaluated on the basis of 41 consecutive hemipelvectomies for malignant tumours. Owing to early metastasization and death, 11 patients were not supplied with prostheses, while prosthetic fitting was attempted in the remaining 30. Of this number 27 completed prosthetic training, with the result that 15 used their prosthesis, while 12 discarded it after some time, six because of poor general health owing to recurrence of the tumours and six because they felt that the prosthesis was too heavy and difficult to wear. Twenty-three returned to work. After elimination of the most severely tumour-affected patients, there were 19 one-year survivors without recurrence. Thirteen of them were using their prosthesis every day, and thirteen had gone back to work. Serious mental sequelae were found in five patients, including four with long-lasting exogenous depressions and one with anxiety neurosis.

Adult↗