[Long-term result of hemicorporectomy]

A 12-year follow up result of hemicorporectomy in a patient is represented. The patient was operated several times since 1983 for massive perianal condylomas. In 1985 the ulcer with hard edges was revealed in the perianal region, spreading to the perineum and root of the scrotum. Biopsy data evidenced for epidermoid carcinoma Abdominoperineal extirpation of the rectum was carried out with broad dissection of the skin of the perineum and with resection of the seminal follicle. Postoperative period was complicated by prolonged pyogenous infection of the perineal wound which prevented from radiation treatment. 9 months later the relapse of the tumor was detected in the perineum with deep pyogenic fistulas formation. 6 courses of chemotherapy by 5-fluorouracyl were carried out. During the process of examination in September 1987 in the perineal area a large massive tumor occupying the whole pelvic cavity and growing into the posterior wall of the urine bladder and left ishial bone, spreading to the scrotal root and surrounded by the net of fistulous tracts was revealed. Hemicorporectomy was carried out with previously layed one-stem sygmostomy keeping intact, and retroperitoneal Y-shaped uretero-ureter anastomosis being formed and right ureter being fixed at the skin of the right abdominal wall. A special prosthesis--"a glass"--was made for the patient, in which he could move from the bed to the chair or the wheeled chair, to move at home or in the street and to drive his own car. Later, evacuation of the uroliths through the uretherocutaneous stoma was observed. Gradually urolithiasis progressed, mainly in the right kidney, and in 1995 the development of purulent rightsided paranephritis was detected which demanded right-sided nephrectomy. Thus, in spite of a number of complications we can state, that hemicorporectomy has cured the patient of advanced, cancer and he feels satisfied with this treatment and saving 12 years of life.