Back-to-Front Hemicorporectomy with Double-barreled Wet Colostomy for Treatment of Squamous Cell Carcinoma of a Pressure Ulcer

Crum, Robert; Lee, Edward S.; Patterson, Francis; Chaudhary, Saad B.; Baranski, Gregg M

doi:10.1177/000313481508101202

Cited by 7 publications

(8 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This involved early division of the vertebral structures and spinal cord, pre-empting engorgement of Batson's plexus, which was purported to minimize blood loss and improve exposure of pelvic vessels. 6 In our practice, we performed the standard method; two stage anterior-to-posterior approach with the usage of thigh flap. The step of operation starts with ligation of main vessel, creating the ureterostomy and colostomy and disarticulation the lumbar spine.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hemicorporectomy: A Case Report

Chalidapong¹,

Arpornchayanon²,

Teeyakasem³

et al. 2019

bkkmedj

View full text Add to dashboard Cite

H emicorporectomy (also known as translumbar amputation, halfectomy) is an operation of amputation of the pelvis and lower extremities by disarticulation through the lumbar spine, as well as creation of conduits for diversion of urinary and fecal tracts. 1 Originally, hemicorporectomy was performed in cases with locally aggressive cancers confined to the pelvis. However, it was also claimed to be beneficial in patients with severe trauma to the pelvis and lower extremities, 2 vascular malformations, acute aortic occlusion, recurrent perianal and scrotal fistulas and terminal pelvic osteomyelitis (this term represents pelvic osteomyelitis with chronic decubitus ulcers which is refractory to treatment with antibiotics and standard surgical treatments). 1,3,4 Hemicorporectomy is not a common operation due to its invasive procedure. However, it can be a life-saving operation with good co-operation among the multi-disciplinary team.The life-threatening intra-operative complication was hypotension, while post-operative wound complications were experienced by all cases. The term 'wound complications' refers to superficial wound dehiscence, delayed wound healing, and osteomyelitis of distal lumbar spine. Genitourinary complications (including recurrent urinary tract infection, pyelonephritis, renal calculi and urosepsis) are also found in many cases. 1 This case report illustrates two cases of patients suffering from malignancy in pelvis and lower extremities. The first case was diagnosed high grade osteosarcoma at sacrum, while the other was recurrent giant cell tumor at left proximal femur. Case reportTwo cases are described in this study. The first case is an 18-year-old female with high grade osteosarcoma at sacrum presented with chronic pelvic pain unalleviated by analgesic drugs. Pathologic examination showed high grade osteosarcoma stage IIB at sacrum. After receiving neoadjuvant chemotherapy, the tumor was not decreased in size and still did not present metastasis. MRI revealed that the tumor had invaded the entire sacrum and all sacral nerve roots with severe soft tissue extension and bony margin surrounding the 5 th lumbar vertebra, shown in Figure 1. AbstractA case report of two successful cases who underwent hemicorporectomy, previously known as translumbar amputation. The first patient was diagnosed high grade osteosarcoma at sacrum. The other was recurrent giant cell tumor at left proximal femur.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Intraoperative bleeding control might be unobtainable. 6. Disease was still not systematically metastasis and curative disease was still expected.…”

Section: Amentioning

confidence: 99%

Hemicorporectomy: A Case Report

Chalidapong¹,

Arpornchayanon²,

Teeyakasem³

et al. 2019

bkkmedj

View full text Add to dashboard Cite

show abstract

“…3,4 This permanent body modifying surgery is a treatment, sometimes curative, for trauma, ulcers, neoplasms or locally extensive and advanced pelvic infectious processes, without distances and cannot be controlled by other treatments. [5][6][7] Examples include pelvic traumatic crushing, pelvic osteomyelitis, squamous cell carcinoma, chondrosarcomas, pressure ulcers complicated by Marjolin's ulcer, all situations considered refractory and intractable. 7,8 Before amputation, the patient's desire and acceptance, the staging of the disease that motivates the indication (tumour, infection, trauma, wound), the clinical and ethical conditions, the prognosis and the possibility of support and social inclusion of the patient must be considered.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Examples include pelvic traumatic crushing, pelvic osteomyelitis, squamous cell carcinoma, chondrosarcomas, pressure ulcers complicated by Marjolin's ulcer, all situations considered refractory and intractable. 7,8 Before amputation, the patient's desire and acceptance, the staging of the disease that motivates the indication (tumour, infection, trauma, wound), the clinical and ethical conditions, the prognosis and the possibility of support and social inclusion of the patient must be considered. 2,9,10 In other words, the risk of death and willingness to live with functional resumption and not just the chances of survival should be evaluated.…”

Section: Introductionmentioning

confidence: 99%

Half man, half prosthesis: the rehabilitation of people with hemicorporectomy – case series

et al. 2021

View full text Add to dashboard Cite

Hemicorporectomy is a procedure where the lumbar spine and spinal cord, pelvic bones and contents, lower extremities and external genitalia are surgically removed. The rehabilitation process, in addition to being prolonged and costly, is challenging. This article reports the rehabilitation process for hemicorporectomy and shows the innovative solutions for mobility for this disability for two cases of paraplegic patients: case 1 due to traumatic spinal cord injury due to firearm injury and case 2 due to lumbosacral myelomeningocele. They presented chronic pressure ulcer which evolved to neoplastic transformation. (squamous cell carcinoma - Marjolin's ulcer). The cases were submitted to L4 hemicorporectomy and were rehabilitated to ensure the right to mobility independence for activities of daily living; social inclusion; prevention of comorbidities and pluralization of disabilities. The rehabilitation involved the elaboration of a new prosthesis for the hemibody and improvement of functional capacity, within a gain of 6 - 11 points in the Functional Independence Measure (FIM). The principal changes happened in social interaction, locomotion and transfers to a bed/chair and toilet. Despite the body transformation, patients show gains in quality of life mainly for the social domain of World Health Organization Quality of Life instrument-brief version (WHOQOL-bref). In general, there is an increase in the scores of this instrument from 1.78% -19.25%. The evolution of social inclusion through the International Classification of Functioning, Disability and Health (ICF) reveals that patients are able to resume social, working, academic-professional life and recreation and leisure activities, reducing the number of severe and complete qualifiers from 90.91 to 60% when using the products appropriate assistive devices. Hemicorporectomy can be a therapeutic option for those in need, as it provides functionality without the need for caregivers and resumes educational, professional, economic and social aspects with gains in quality of life.

show abstract

“…Currently, the treatment for PUs involves various approaches, such as support surfaces, nutritional supports, wound dressings, and surgical operation. [ 8 ] The most common and effective treatment for stage 3 or 4 PUs is lesion resection [ 9 ] ; however, the optimal method to repair the tissue defects after excision remains debated. The gluteus maximus myocutaneous flaps (GMMs) has historically been used in the treatment of tissue defects, although the occurrence of postoperative complications was gradually revealed as an increasing number of operations were performed.…”

Section: Introductionmentioning

confidence: 99%

Application of gluteus maximus fasciocutaneous V-Y advancement flap combined with resection in sacrococcygeal pressure ulcers

Liu

Lu²,

Zhang

et al. 2017

Medicine

View full text Add to dashboard Cite

Background:Traditional gluteus maximus myocutaneous flaps have generally been used to fill tissue defects after resection of sacrococcygeal pressure ulcers. However, postoperative complications were gradually revealed as increasing operations were performed. This study aimed to introduce the innovative application of gluteus maximus fasciocutaneous V-Y advancement flaps for repairing tissue defects and to comparatively analyze the differences between the innovative and traditional flaps.Methods:A total of 32 cases were included in this study. All the PU lesions were removed by resection. Sixteen cases used the gluteus maximus myocutaneous flaps, and the remaining 16 cases used gluteus maximus fasciocutaneous V-Y advancement flaps to fill the tissue defects after surgery. Comparative analysis between the gluteus maximus myocutaneous flaps and gluteus maximus fasciocutaneous V-Y advancement flaps was used to evaluate the 2 flaps based on the mean operating time, postoperative infection, paresthesia, appearance of flaps, and recurrence.Results:The gluteus maximus fasciocutaneous V-Y advancement flaps required a reduced operating time and a more simple operation compared with the gluteus maximus myocutaneous flaps. Although the infectious risk of the gluteus maximus fasciocutaneous V-Y advancement flaps was reduced compared with the gluteus maximus myocutaneous flaps, the gluteus maximus myocutaneous flaps have a better appearance compared with the gluteus maximus fasciocutaneous V-Y advancement flaps. Most importantly, no flap necrosis was noted, and the recurrence rate during follow-up was reduced in cases using the gluteus maximus fasciocutaneous V-Y advancement flaps.Conclusion:The combined application of gluteus maximus fasciocutaneous V-Y advancement flaps with surgical resection can reduce the postoperative complications and aid in the treatment of sacrococcygeal pressure ulcers.

show abstract

Back-to-Front Hemicorporectomy with Double-barreled Wet Colostomy for Treatment of Squamous Cell Carcinoma of a Pressure Ulcer

Cited by 7 publications

References 3 publications

Hemicorporectomy: A Case Report

Hemicorporectomy: A Case Report

Half man, half prosthesis: the rehabilitation of people with hemicorporectomy – case series

Application of gluteus maximus fasciocutaneous V-Y advancement flap combined with resection in sacrococcygeal pressure ulcers

Contact Info

Product

Resources

About