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Type 3 internal hemipelvectomy: a report of two cases
Jungo Imanishi1, Yasuo Yazawa1, Hiromi Oda2
1Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Centre, Hidaka, Saitama, Japan.
Journal of Orthopaedic Surgery (Hong Kong)
|September 1, 2015
Summary
Type 3 internal hemipelvectomy, a pelvic surgery, can lead to complications like hernia and fractures. Surgical modifications and follow-up are crucial for managing these risks in patients undergoing this procedure.
Area of Science:
- Surgical Oncology
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Type 3 internal hemipelvectomy necessitates the resection of the pubis, posing unique surgical challenges.
- Pelvic resections, including hemipelvectomy, are complex procedures often associated with significant morbidity.
Observation:
- Two patients undergoing type 3 internal hemipelvectomy experienced distinct complications.
- One patient developed bladder hernia, tumor recurrence, and proximal femur fracture, requiring subsequent external hemipelvectomy.
- The second patient received fascia lata transplantation to mitigate hernia risk, and both patients presented with contralateral iliac stress fractures.
Findings:
- Type 3 internal hemipelvectomy can result in pelvic floor defects, leading to complications such as bladder hernia.
- Tumor recurrence and pathological fractures are potential sequelae following extensive pelvic resections.
- Iliac stress fractures in the contralateral pelvis can occur post-hemipelvectomy, potentially mimicking metastatic disease.
Implications:
- Careful surgical planning and reconstruction are vital to minimize complications after type 3 internal hemipelvectomy.
- Prophylactic measures, like fascia lata transplantation, may help prevent hernias in these patients.
- Radiological surveillance should consider the possibility of stress fractures in the contralateral pelvis, distinguishing them from bone metastases.
