Hemicorporectomy: a nursing challenge

After 10 years of recurring giant cell tumor of the back, a 32-year-old man faced the most difficult decision of his life: whether or not to undergo a hemicorporectomy. This radical surgery, which removes the lower half of the body, is generally not performed until other avenues of treatment have been tried. Up to 1982 there were only 24 hemicorporectomies reported in the literature. For many nurses this surgical procedure is unfamiliar, and many nurses will probably never care for a patient having had a hemicorporectomy, but the difficulties facing this patient may be faced by many amputation patients. As primary nurses for this case we developed a preoperative and postoperative care plan encompassing his major nursing diagnoses: pain, mobility, nutrition, and coping. The implications of cost, rehabilitation, and radical changes in lifestyle and appearance are serious questions facing a patient considering this surgery. Addressing these problems professionally requires a multidisciplinary approach with patients and families through education, motivation, and support. This article discusses some of these issues as seen with this particular patient.