Mackenzie A R
Department of Surgery, Long Beach Medical Center, NY, USA.
Mt Sinai J Med. 1995 Sep;62(4):305-7.
Translumbar amputation, known also as hemicorporectomy, was first described by Kredel but was not performed until 10 years later in 1960. It appears that 44 such operations have been reported but probably several others remain unpublished.
The operation has been performed in 44 reported patients over the past 30 years in more or less the same fashion. Most have been done as a one-stage procedure, but the author favors laparotomy and maturation of urinary and fecal diversions before doing the amputation about two weeks later.
Overhydration caused the death of the first three patients. This problem was avoided in the Memorial Sloan-Kettering patients by careful monitoring of central venous pressure. There were no operative deaths, but 8 of the 44 patients died within a month. Survival of cancer patients has not been good, but those with benign lesions have survived fairly well.
This case is remarkable in that, despite a rapidly advancing cancer of the bladder, the patient lived for over 28 years. It is gratifying to see that other surgeons and patients have not abandoned this most radical of all operations when no other therapy can preserve life.
经腰截肢术，也称为半体切除术，最早由克雷德尔描述，但直到1960年，也就是10年后才得以实施。据报道，此类手术已进行了44例，但可能还有其他几例未发表。
在过去30年里，已对44例患者实施了该手术，手术方式大致相同。大多数手术是一期完成的，但作者倾向于先进行剖腹手术，同时使尿路和粪便转流成熟，大约两周后再进行截肢手术。
最初的3例患者因补液过量死亡。纪念斯隆凯特琳癌症中心的患者通过仔细监测中心静脉压避免了这个问题。术中无死亡病例，但44例患者中有8例在一个月内死亡。癌症患者的生存率不佳，但患有良性病变的患者存活情况较好。
该病例值得注意的是，尽管患者患有迅速进展的膀胱癌，但仍存活了28年多。令人欣慰的是，当没有其他疗法能够挽救生命时，其他外科医生和患者并未放弃这种最为激进的手术。
