Hemipelvectomia: experiência do Hospital Erasto Gaertner com 32 casos em 10 anos

Internal hemipelvectomy (IH) is a newer surgical choice for pelvic tumors. It involves resection of the tumor, reconstruction of the pelvis without sacrificing the neurovascular structures, and preservation of the lower limb. We aimed to describe first experience with IH in primary pelvic tumors in Peru. Four patients aged 17 to 49 years old at the time of diagnosis were included. 75% were chondrosarcomas, and 25% were chondroblastomas. The IH types were 50% type II, 25% type I-A, and 25% type III. The neoplasm sizes differed from 5 cm to more than 20 cm. Postoperative complications were right hip arthrosis, transient urinary incontinence, and abdominal eventration. Fifty percent had local recurrence, with a recurrence mean time of 24 months. As a first attempt at this technique in Peru, IH had promising results with a 100% overall survival at 30 months. However, more studies are required to analyze the factors associated with a high rate of recurrence (50%).

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Internal hemipelvectomy for primary pelvic tumors, first experience in Peru: a case series

Bilbao-Calsine

Guerra-Canchari

Brañez-Condorena

et al. 2021

Current Orthopaedic Practice

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Outcomes of internal hemipelvectomy for pelvic tumors: a developing country’s prospective

Ali

Rashid

Mohib

et al. 2017

International Journal of Surgery Oncology

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Introduction:Previously, external hemipelvectomy was the mainstay of treatment for pelvic tumors. However, with technological advancements, limb salvage procedures such as internal hemipelvectomy have emerged as a viable alternative. However, there is limited literature available on long-term outcomes and complications of internal hemipelvectomy, especially from developing countries. Therefore, the objective of this study was to share our experience of internal hemipelvectomy at a tertiary care center in a developing country.Materials and methods:A retrospective review was conducted in which all 24 patients undergoing internal hemipelvectomy from January 1, 2005 to December 31, 2015 at our institution were included. Medical record files were reviewed for intraoperative and early and late postoperative complications, and functional outcomes were assessed by contacting each patient on telephone.Results:Ewing sarcoma was found to be the most common diagnosis, followed by osteosarcoma as the second most common. The mean follow-up period was 18.7±13.9 months. Intraoperatively there were 4 cases of iatrogenic neurovascular injury and 2 cases each of urinary tract injury and dural tear. Four patients developed early wound infections, 7 developed late wound infections, and 2 developed flap necrosis. Three patients developed recurrence, whereas 7 patients developed metastasis postoperatively. The mean survival was calculated to be 28 months and the mean Musculoskeletal Tumor Society score was 19.3±5.2.Conclusions:Outcomes and prevalence of complications shown in this study are comparable to those in the international literature, which suggests that hemipelvectomy is a viable option in developing countries also. However, more such studies are warranted to validate the findings and to identify the challenges and morbidities associated with hemipelvectomy in Asian and developing countries.

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Three‐dimensional‐printed customized prosthesis for pubic defect: clinical outcomes in 5 cases at a mean follow‐up of 24 months

Zhang

et al. 2021

BMC Musculoskelet Disord

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Background Pubic defects resulting from type III hemipelvectomy are commonly not reconstructed due to the need to preserve the weight-bearing axis. However, the opening of the anterior pelvic ring will inevitably lead to increased pelvic instability. To improve long-term pelvic stability, three-dimensional (3D)-printed customized prostheses were designed to reconstruct pubic defects. This study presents and evaluates the short-term clinical outcomes and complications from the use of this construct. Methods Five patients who underwent type III hemipelvectomy and 3D-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analysed. Operation time and blood loss during the operation were recorded. Local and functional recovery was assessed. Prosthetic position and osseointegration were evaluated. Oncology results and complications were recorded. Results The prostheses consisted of three with stems and two without. The mean follow-up time was 23.6 months. At the last follow-up, all five patients were alive with no evidence of disease. No deep infections or local recurrence had occurred. The mean blood loss and mean intraoperative time were 1680 ml and 294 min, respectively. The mean functional MSTS score at the final follow-up was 29.8. Fretting wear around the prosthetic stem was found in 3 patients, while bone wear on the normal-side pubis was found in 2 patients. Osseointegration was observed in all patients. Conclusions 3D-printed customized prostheses for reconstructing pubic bone defects after type III hemipelvectomy showed acceptable early outcomes. The good outcomes were inseparable from the precision prosthesis design, strict surgical procedures, and sensible postoperative management.

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Hemipelvectomia: experiência do Hospital Erasto Gaertner com 32 casos em 10 anos

Abstract: declaramos inexistência de conflito de interesses neste artigo aRtIgO ORIgINaL hemipelvectomiA: experiênciA do hospitAl erAsto gAertner com 32 cAsos em 10 Anos

Cited by 6 publications

References 12 publications

Internal hemipelvectomy for primary pelvic tumors, first experience in Peru: a case series

Internal hemipelvectomy for primary pelvic tumors, first experience in Peru: a case series

Outcomes of internal hemipelvectomy for pelvic tumors: a developing country’s prospective

Three‐dimensional‐printed customized prosthesis for pubic defect: clinical outcomes in 5 cases at a mean follow‐up of 24 months

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