Internal hemipelvectomy for bone sarcomas in children and young adults: surgical considerations

Kollender, Y.; Shabat, Shay; Bickels, Jacob; Flusser, Gideon; Isakov, J; Neuman, Yoram; Cohen, Inbal; Weyl-Ben-Arush, M.; Ramo, N.; Meller, I.

doi:10.1053/ejso.1999.0906

Cited by 48 publications

(39 citation statements)

References 27 publications

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“…Operation duration is also important to blood loss of pelvic tumour surgery. In most reports of primary or metastatic pelvic tumours, the average operation time was three to six hours and sometimes even more than ten hours [2,5,15,23]. In our study, the mean operation time was nearly four hours and time for reconstruction was around one hour.…”

Section: Discussionmentioning

confidence: 40%

Evaluation of blood loss during limb salvage surgery for pelvic tumours

Tang

Guo

Yang

et al. 2008

International Orthopaedics (SICOT)

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As a large amount of blood loss is sometimes encountered in limb salvage procedures for pelvic tumours, it is essential to identify risk factors predicting the possibility of extensive haemorrhage. We retrospectively reviewed 137 patients who underwent pelvic tumour resections. Patients with an estimated blood loss greater than 3,000 ml were classified as having a large amount of blood loss. Sixty-one (44.53%) patients had blood loss greater than 3,000 ml. Tumours involving the acetabulum or sacrum, tumour volume greater than 400 cm 3 , aorta occlusion, resection method, reconstruction and operative time were all associated with a large amount of blood loss. Pelvic tumours involving the acetabulum or sacrum (odds ratio: 4.837), tumour volume greater than 400 cm 3 (odds ratio: 3.005) and planned operation time of more than 200 min (odds ratio: 3.784) independently predicted a large amount of blood loss. Pelvic tumours with these characteristics were likely to have a large amount of blood loss during surgery.

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Section: Discussionmentioning

confidence: 40%

Evaluation of blood loss during limb salvage surgery for pelvic tumours

Tang

Guo

Yang

et al. 2008

International Orthopaedics (SICOT)

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“…Although postoperative complications were common in our series (43%), most were minor and healed well with antibiotics and one I & D. Our major complications were not life-threatening and most required only I & D. Other studies report postoperative complication rates of 31% to 60% [3,8,28] for internal hemipelvectomy, with the highest incidences being infection (7%-50%) [1,4,8,10,22] and wound healing problems (13%-29%) [1,4,8,10,28]. Our infection rate was 20% and our wound complication rate also was 20%.…”

Section: Discussionmentioning

confidence: 57%

Internal Hemipelvectomy for Pelvic Sarcomas Using a T-incision Surgical Approach

Lackman

Crawford

Hosalkar

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Internal hemipelvectomy is performed for pelvic sarcomas when the tumor can be safely resected without sacrificing the entire extremity. Wide exposure and awareness of major neurovascular structures are crucial to the success of this surgery. Various modifications on the standard utilitarian approach have been used to best achieve these goals. We reviewed our experience using the T-incision technique for 30 pelvic sarcoma resections. The minimum followup was 3.6 months (mean, 55 months; range, 3.6-185.4 months). Postoperative complications included minor complications (requiring no surgery or a simple incision and drainage with primary closure) in 27% of patients and major complications (involving a deep infection or more extensive surgical treatment) in 17%. Ninety-two percent of wound complications healed uneventfully with antibiotics and incision and drainage.The 2-, 5-, and 10-year patient survival rates were 67%, 59%, and 53%. The 2-, 5-, and 10-year disease-free survival rates were 68%, 42%, and 42%. The mean Musculoskeletal Tumor Society and Toronto Extremity Salvage Scores were 69% and 86%, respectively. We believe the T-incision technique for internal hemipelvectomy is an effective surgical approach for pelvic sarcomas when limb salvage is possible.

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“…There have been only five previous reports of internal pelvic resections replaced with an allograft and a hip prosthesis (Table 3). It is difficult to compare those results with results of our series because of differences in tumor type, extent of resection, reconstruction methods, and length of followup [13]. Additionally, comparison of periacetabular reconstruction outcomes is hampered by differences in the source and treatment of the grafts [12,17].…”

Section: Discussionmentioning

confidence: 99%