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Abstract
Emergency hemipelvectomy (HP) is a rare procedure. Only three incidents have been
previously reported. This paper describes six additional cases, analyzes our results,
and sets forth criteria for patient selection. There were five men and one woman.
The median age was 38.5 years. Primary underlying diseases were sarcoma (three cases),
peripheral vascular disease (one), deep vein thrombosis (one), and drug abuse (one).
Life-threatening peripelvic sepsis and hemorrhage were indications for emergency HP.
All six patients had multiple procedures prior to definitive HP. Four classical and
two modified HPs were performed. The mean operative time was 3.5 hours, the mean blood
loss 2292 ml. There were no intraoperative complications. The median duration of hospitalization
was 56 days. Five of six patients were saved. Life-threatening peripelvic sepsis or
hemorrhage associated with tumor recurrence, radiation, or failed vascular reconstruction
is an indication for emergency HP. Neither age nor physical condition should be a
deterrent. The patient should not be allowed to advance to a premorbid state before
HP is considered, although concomitant intra-abdommal disease is a contraindication.
HP is recommended in lieu of hip disarticulation. We anticipate that the need for
emergency HP will increase as limb salvage procedures for extremity sarcomas and dysvascular
disease become more frequent.
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References
- Amputations in peripheral vascular occlusive disease.Am J Surg. 1978; 135: 231-234
- Hindquarter amputation.J Bone Joint Surg. 1949; 31-B: 404-409
- Appraisal of progress in surgical therapy. Indications for hemipelvectomy.Surgery. 1958; 44: 766-774
- Hemipelvectomy for tumors of bone Report of fourteen cases.Am J Surg. 1954; 82: 27-43
- Use of a tubed thoracoepigastric flap to cover the defect from a hindquarter amputation. Case report.Plast Reconstr Surg. 1978; 61: 112-114
- Hemipelvectomy.Arch Surg. 1975; 110: 82-85
- Elderly amputee.Lancet. 1972; 2: 747
- Radical amputations.in: Nora's operative surgery. Lea & Febiger, Philadelphia1974: 1041-1051
- A new technique for hemipelvectomy.Surg Gynecol Obstet. 1976; 143: 753-756
- Desarticulation de l'os iliaque pour sarcome.Rev Chir. 1895; 15: 952
- Sur la desarticulation interilio-abdominale.Rev Chir. 1898; 18: 1141-1142
- Interinnomino-abdominal (hind-quarter) amputation.Br J Surg. 1935; 22: 671-695
- The interinnomino-abdominal operation. Observations on a series of fifty cases.J Bone Joint Surg. 1952; 34-B: 14-21
- Treatment of burns with hyperbaric oxygen.Surg Gynecol Obstet. 1974; 139: 693-696
- Hemipelvectomy: Experience in series of thirty-nine cases.Cancer. 1956; 9: 1233-1238
- Hemipelvectomy: A clinical study of 100 cases with five year follow-up on 60 patients.Surgery. 1966; 59: 706-708
- Hindquarter amputations.Br Med J. 1974; 4: 4-5
- Gangrene infection. New approaches to an old disease.Surg Clin North Am. 1975; 55: 1403-1410
- Experimental and clinical experience with hyperbaric oxygen in the treatment of clostridial myonecrosis.Surgery. 1975; 77: 75-85
- Emergency hemipelvectomy.Am J Surg. 1954; 88: 340-342
- The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis.Surg Gynecol Obstet. 1972; 135: 561-567
- Major amputation following vascular reconstructive procedures (including sympathectomy).Can J Surg. 1978; 21: 456-458
- Radical surgery for cancer of the extremities.Am J Surg. 1953; 85: 503-512
- Lower-limb amputation for occlusive vascular disease.Am Surg. 1976; 42: 598-601
- Effects of hyperbaric oxygenation and prolonged hypoxia on the healing of open wounds.Acta Chir Scand. 1975; 141: 14-19
- Hemipelvectomy and hip disarticulation for malignant tumors of the pelvis and lower extremity.Ann Surg. 1953; 137: 704-717
- Hemipelvectomy for malignant disease.JAMA. 1957; 165: 8-12
- Traumatic hemipelvectomy: Case report and literature review.J Trauma. 1975; 15: 541-545
- Survival and ambulation following hip fracture.J Bone Joint Surg. 1978; 60-A: 930-934
- Interilio-abdominal amputation. A report of 32 cases.Acta Radiol (Stockholm). 1959; : 173-189
- Hemipelvectomy in the treatment of advanced cancer.Am J Roentgenol. 1962; 87: 531-535
- 100 Cases of hemipelvectomy. A personal experience.Surg Clin North Am. 1974; 54: 905-913
- Hemipelvectomy in lower extremity tumors.Orthop Clin North Am. 1977; 8: 903-919
- Traumatic hemipelvectomy—The tenth survivor: A case report and a review of the literature.Injury. 1978; 9: 307-312
- Radical amputations of the extremities in the treatment of cancer.Surg Gynecol Obstet. 1947; 84: 1105-1116
- Exarticulation of the innominate bone and corresponding lower extremity (hemipelvectomy) for primary and metastatic cancer. A report of one hundred and one cases with analysis of the end results.J Bone Joint Surg. 1964; 46-A: 91-95
- Effect of varying oxygen tensions on healing of open wounds.Surg Gynecol Obstet. 1972; 135: 756-758
- Long-term results of hemipelvectomy.Ann Surg. 1964; 159: 667-682
- Limb ablation and limb replacement. Amputation in vascular disease.Ann R Coll Surg Eng. 1980; 62: 87-91
- Osteosarcoma and emergency hind-quarter amputation—A case report.Med J Zambia. 1978; 12: 104-106
- Traumatic hemipelvectomy: A case report.J Trauma. 1977; 17: 245-247
- Hemipelvectomy: Postoperative rehabilitation assessed on the basis of 41 cases.Acta Orthop Scand. 1978; 49: 175-179
- Disarticulation of the innominate bone for malignant tumors of the pelvic parietes and upper thigh.Surg Gynecol Obstet. 1945; 81: 36-52
- A case of traumatic hindquarter amputation.Br J Surg. 1978; 65: 390-392
- Pulmonary embolism after amputation of the lower extremity.Surg Gynecol Obstet. 1975; 140: 246-248
Article info
Publication history
Accepted:
October 8,
1982
Identification
Copyright
© 1983 Published by Elsevier Inc.
