Arkoulis Nikolaos, Savanis Georgios, Simatos Georgios, Zerbinis Helen, Nisiotis Athanasios
Department of Clinical Surgery, University of Edinburgh, 51 Little France Dr, EH16 4SA, UK.
Int J Surg Case Rep. 2012;3(7):316-8. doi: 10.1016/j.ijscr.2012.04.002. Epub 2012 Apr 9.
Hemipelvectomies are uncommon operations, usually performed for primary or metastatic malignant disease and less frequently for benign-aggressive tumours. There are very few reports in literature regarding complications of these procedures and even fewer reports about post hemipelvectomy hernias in particular.
We present the only reported case of an incisional hernia of the urinary bladder following internal hemipelvectomy for aneurysmal bone cyst of the pubic bone. A careful literature review is also performed.
The development of the incisional hernia in the case of our patient can most likely be explained by the absence of advanced malignant disease of the pelvis that not only reduces the life expectancy but also overshadows other complications post hemipelvectomy. Furthermore, her young age and level of fitness allowed for a full postoperative rehabilitation which, combined with the proven anatomical changes of the internal organs following hemipelvectomies and the weakening of the tissues around the operative site, predisposed to the hernia formation.
Hemipelvectomies are extensive, anatomically disruptive operations, with significant detriment to the psychosomatic well being of the patients. We presented the only reported case of incisional hernia of the urinary bladder following internal hemipelvectomy and our reconstructive method of choice. We believe that, in the case of our patient, if a mesh had been used to reconstruct the primary defect during the initial surgery, this complication could have been prevented.
半骨盆切除术是一种不常见的手术，通常用于治疗原发性或转移性恶性疾病，较少用于侵袭性良性肿瘤。关于这些手术并发症的文献报道非常少，尤其是关于半骨盆切除术后疝的报道更是少之又少。
我们报告了耻骨骨动脉瘤样骨囊肿行内半骨盆切除术后唯一一例膀胱切口疝的病例。同时还进行了详尽的文献回顾。
我们患者发生切口疝最可能的原因是骨盆无晚期恶性疾病，这不仅缩短了预期寿命，还掩盖了半骨盆切除术后的其他并发症。此外，她年轻且身体状况良好，术后能够进行全面康复，再加上半骨盆切除术后证实的内脏解剖结构变化以及手术部位周围组织的弱化，这些因素共同促使了疝的形成。
半骨盆切除术是广泛的、具有解剖破坏性的手术，对患者的身心健康有重大损害。我们报告了内半骨盆切除术后唯一一例膀胱切口疝的病例以及我们选择的重建方法。我们认为，就我们的患者而言，如果在初次手术时使用补片来修复原发缺损，这种并发症本可避免。
