Partial and complete internal hemipelvectomy: complications and long-term follow-up.

BACKGROUND

The complications and long-term follow-up results of internal hemipelvectomy are not well documented.

STUDY DESIGN

We reviewed 32 internal hemipelvectomies performed between 1976 and 1994.

RESULTS

The pathologic diagnoses were soft tissue sarcoma in 15 cases, bone tumor in 14 cases, melanoma in two cases, and carcinoma in one of the cases. In 24 cases, the intent of surgery was curative; in 22 cases, the procedure was modified. Average blood loss was 3.2 L; the procedure took on average 7.5 hours. Complications included skin flap necrosis in four cases, infection in 15 cases, and various other complications in five cases. Three mortalities (9 percent) occurred. Thirty-four percent of the patients ambulated without any assistance, 59 percent ambulated with crutches, while 7 percent remained wheel-chair bound. The survival rate after resection for cure was 45 percent at ten years compared with 29 percent at two years for palliative resections.

CONCLUSIONS

Internal hemipelvectomy is a complex procedure that is functionally and cosmetically superior to external hemipelvectomy and, when done with curative intent, results in considerable long-term survival rates.