Posthemipelvectomy hernia

Trill, Javier Díe; Madrid, Jose Manuel; Ferrero, Eduardo; Igea, J; Torres, Antonio; Gómez, José Luis Zamorano; Medina, I.; Canales, Cecilia; Perea, F.; Carda, Pedro; Villanueva, A. García; Goyanes, Alfredo Die

doi:10.1007/s10029-005-0328-8

Cited by 13 publications

(10 citation statements)

References 10 publications

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“…The inguinal fl oor should be appropriately reconstructed from the pubic tubercle to the lateral ilium to prevent peritoneal hernias. 40 In addition, care should be taken for repositioning the femoral vessels (and in men the spermatic cord and contents) into the retroperitoneal space.…”

Section: Type III Resectionsmentioning

confidence: 99%

Pelvic Resections

Mavrogenis¹,

Soultanis²,

Patapis³

et al. 2012

Orthopedics

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The complexity of pelvic anatomy and the extent of tumor growth makes treatment of patients with primary bone sarcomas in the pelvis difficult in terms of local control. Before the 1970s, most tumors in the bony pelvis were surgically treated with hindquarter amputation. Currently, improved techniques for clinical staging, adjuvant treatments, evolutions in metallurgy, and development of new surgical techniques make limb-salvage surgery and reconstruction possible alternatives to hemipelvectomy and resection-arthrodesis. The advantages of amputation over resections at the pelvis are a lower incidence of complications, a limited area at risk for recurrence, and a faster recovery time compared with all but the most limited pelvic resections. The disadvantages, especially after periacetabular resections, are leg-length discrepancy and impaired hip and gait function. The indication for limb salvage is the ability to obtain wide margins without compromising survival and function. Although having to resect the sciatic nerve to obtain adequate margins does not always mean that an amputation should be performed, the combination of a major pelvic resection and the functional consequences of sciatic nerve resection results in an extremity usually not worth saving; loss of femoral nerve function does not result in a significant gait disturbance, especially if the hemipelvis is stable. Reconstruction options after major pelvic resections have also evolved, but they remain difficult, especially when the acetabulum is involved.

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Section: Type III Resectionsmentioning

confidence: 99%

Pelvic Resections

Mavrogenis¹,

Soultanis²,

Patapis³

et al. 2012

Orthopedics

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“…4,5 In the case of our patient, a type 3 internal hemipelvectomy with resection of the pubic bone and symphysis pubis was performed for a 6-cm aneurysmal bone cyst, which is a benign, albeit aggressive, tumour. The patient was quite young at the time of the primary surgery (17 years old) and her incisional hernia did not become symptomatic until 8 years post-operatively.…”

Section: Discussionmentioning

confidence: 97%

“…Postoperative hernia formations, in particular, appear to be documented very scarcely in literature and even then, they are usually associated with external, rather than internal, hemipelvectomies. [2][3][4][5] We present a case of a female patient, who developed a postoperative incisional hernia of the urinary bladder following internal hemipelvectomy for an aneurysmal bone cyst. To our knowledge, this is the only reported case of bladder hernia following such a procedure.…”

Section: Introductionmentioning

confidence: 98%

“…6 While external hemipelvectomies invariably result in hindquarter amputations and are therefore associated with high functional and psychological morbidity, 1 internal hemipelvectomies allow preservation of the limb and have become, in certain cases, a safe alternative that has been successfully used for the treatment of benign-aggressive tumours, primary sarcomas or metastatic disease. [3][4][5][6] Due to the fact that hemipelvectomies are uncommon operations performed for conditions with high mortality rates, the available literature examining their complications is scant. Postoperative hernia formations, in particular, appear to be documented very scarcely in literature and even then, they are usually associated with external, rather than internal, hemipelvectomies.…”

Section: Introductionmentioning

confidence: 99%

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Incisional hernia of the urinary bladder following internal hemipelvectomy

Arkoulis

Savanis

Simatos

et al. 2012

International Journal of Surgery Case Reports

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Hemipelvectomies are extensive, anatomically disruptive operations, with significant detriment to the psychosomatic well being of the patients. We presented the only reported case of incisional hernia of the urinary bladder following internal hemipelvectomy and our reconstructive method of choice. We believe that, in the case of our patient, if a mesh had been used to reconstruct the primary defect during the initial surgery, this complication could have been prevented.

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“…However, lots of complications were reported after type III hemipelvectomy without reconstruction. Hernia and sacroiliitis were the most common complications and frequently reported as late complications in patients without reconstruction after type III hemipelvectomy (7,8). Firstly, bony reconstruction provides an anchor for mesh and suture attachments, which adding to the integrity of pelvic oor soft tissue reconstructions.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

et al. 2020

Preprint

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Background This study is to present and evaluate the short-term clinical outcomes and associated complications of 3D-printed customized prostheses for pubic defect reconstruction. Methods 5 patients receiving type III hemipelvectomy and three-dimensional-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analyzed in this study. The operation time and blood loss during operation were recorded. The local and functional recovery was assessed by the physical examination and Musculoskeletal Tumor Society (MSTS) score. The prosthetic position and Osseointegration were evaluated by imaging examination. Oncology result and complications were recorded. Functional comparisons with MSTS score of patients grouped by resection extent were done. Results Of 5 cases, the prosthese consist of the type with stem (3, 60%) and the type without stem (2, 40%). Mean follow-up period was 17.6 months (range, 10–26 months). All 5 patients were alive with no evidence of disease. No deep infection and local recurrence occurred. The mean blood loss and mean intraoperative time was 1680 ml (range, 300 to 3700 ml) and 294 min (range, 180 to 430 min). The mean functional MSTS score at the final follow-up was 29.8 (range, 29–31). 1 male patient complained erectile dysfunction. Fretting wear around 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. Conclusion 3D-printed customized prostheses could be a feasible option to reconstruct the pubic bone defects after type III hemipelvectomy. The good outcomes are inseparable from precision prostheses design and strict surgical procedures.

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Posthemipelvectomy hernia

Cited by 13 publications

References 10 publications

Pelvic Resections

Pelvic Resections

Incisional hernia of the urinary bladder following internal hemipelvectomy

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

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