What is Hemipelvectomy: Overview, Benefits, and Expected Results

Definition and Overview

Hemipelvectomy is the surgical removal of half of the pelvis usually for the treatment of localized tumors and, rarely, for cancer that has metastasized to the area.

Half pelvis removal may be classified as external or internal. The former involves the resection of the bones of the pelvis and the amputation of the leg on the same side, which is usually followed up by the fitting of prostheses. The latter, on the other hand, spares the limb but removes the diseased bones and tissues.

Surgical reconstruction is a standard after hemipelvectomy and involves the use of flap procedure or graft technique that recreates the pelvis and protects the remaining structures as well as the attached metal screws and plates from exposure. Reconstruction surgery is also performed to reduce the possibility of a hernia from developing.

Who Should Undergo and Expected Results

Many factors are considered before a half pelvis removal is performed. These include age, type and severity of the disease, actual location of tumors, gender, and possible risks and complications.

When performed for cancer treatment, it is typically recommended to patients with osteosarcomas (bone cancer) specifically Ewing’s sarcoma and chondrosarcoma. It is also ideal if the tumor is localized or contained within the pelvic area, although in some – and rare – cases, the surgeon may perform the procedure on a metastasized tumor.

In scenarios where the patient has already undergone other types of surgeries and treatments related to cancer, hemipelvectomy is explored if the patient has become non-responsive to these therapies or if the localized tumor has become recurrent.

Hemipelvectomy may also be necessary if the pelvis has been severely damaged due to a traumatic injury like a vehicle accident or if the leg on the same side has already lost its function.

The surgery can be used as a treatment for diseases or as part of palliative care, which means it can be performed to extend the patient’s quality of life. However, with the pelvis and sometimes the leg removed, the patient may be at risk of developing bone-related deformities such as scoliosis or back pain, which can be controlled or improved with regular physical therapy.

How Does the Procedure Work?

Hemipelvectomy is usually performed by making a large incision either in the perineum, which is near the anus, or ilioinguinal, which is part of the lumbar nerves located at the back of the body. The tumor along with a healthy tissue that serves as a clear margin are then excised and sent to a lab to assess the extent of cancer. Depending on the size, location, and spread of tumors, more bones and tissues may be removed until the tissue come back clean. If necessary, the leg on the same side is also amputated.

The surgeon then proceeds with reconstructing the affected body part usually through an allograft, (tissue from a human donor) or autograft, in which the skin is obtained from the patient’s body which is usually the thigh.

Before the procedure is completed, a Foley catheter is inserted to facilitate the draining of urine while the wound is still healing. The incisions are then sutured properly.

Possible Risks and Complications

Two of the serious risks and complications of the procedure is extensive bleeding and infection due to the proximity of the resected area to the bowel. For this reason, surgeons provide patients with antibiotics during pre-operative care.

Half pelvis removal is one of the rarest procedures performed in the lower extremities, which can pose a challenge for both patients and surgeons. It may be difficult for patients to find surgeons who have the knowledge, expertise, and experience to perform the procedure precisely while surgeons may struggle with all the possible risks and complications.

References:

• Apffelstaedt JP, Driscoll DL, Karakousis CP. Partial and complete internal hemipelvectomy: complications and long-term follow-up. J Am Coll Surg. 1995;181:43-48.

• Apffelstaedt JP, Zhang PJ, Driscoll DL, Karakousis CP. Various types of hemipelvectomy for soft tissue sarcomas: complications, survival and prognostic factors. Surg Oncol. 1995;4:217–222.

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## What is Hemipelvectomy: Overview, Benefits, and Expected Results



**Overview**



Hemipelvectomy is a surgical procedure that involves the removal of half of the pelvis, including the leg on that side. It is typically performed to treat advanced​ bone cancer that has spread to the pelvis. In⁢ some cases, it may also be⁢ used to treat severe pelvic ⁢injuries or infections.



**Benefits**



Hemipelvectomy can​ provide several benefits, including:



* ‌**Tumor removal:** The primary goal of ‌hemipelvectomy is to remove the cancerous tumor. ‌This can potentially lead to⁢ a cure if the ⁢cancer⁣ has not⁢ spread beyond the​ pelvis.

* **Pain ‍relief:** Hemipelvectomy can relieve pain caused by a pelvic tumor‌ or injury.

* **Improved function:** Hemipelvectomy can⁤ improve function⁣ by ‍removing ‍a leg⁤ that is‍ causing⁢ pain or impairing movement.



**Expected Results**



The expected results of⁤ hemipelvectomy depend on the underlying condition being treated and the patient’s individual circumstances. In general, most patients who undergo hemipelvectomy will experience:



* **Recovery time:** The recovery time from hemipelvectomy can be lengthy and challenging. Patients ​typically‌ need several months to ⁣adjust to their new ⁢physical‌ condition.

* **Need for assistive devices:** Most patients who undergo hemipelvectomy will require the use ​of assistive devices, such as a ⁢wheelchair or crutches,​ to ⁢move around.

* **Lymphedema:** Hemipelvectomy can increase the risk ⁢of​ developing lymphedema, a condition that causes ⁣swelling due to fluid⁤ retention.

*⁤ **Emotional impact:** ‍Hemipelvectomy ‍can have a significant emotional impact on patients.‍ It is important for ⁣patients‍ to have support⁢ from family, friends,⁢ and medical professionals during this‍ time.



**Conclusion**



Hemipelvectomy is a major surgical procedure with potentially life-changing consequences. However, for patients with advanced bone cancer or severe‍ pelvic injuries or infections, hemipelvectomy can offer significant benefits in terms of tumor removal, pain relief,‌ and improved function. It is important⁣ for patients⁣ to understand the potential⁣ risks⁢ and benefits of this procedure before making a decision about whether or not to undergo surgery.



**Related Keywords:**



* Hemipelvectomy

* Bone cancer

* Pelvic injuries

* Pelvic infections

* Tumor removal

* Pain relief

* Improved function

* Recovery time

* Assistive devices

* Lymphedema