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Urological Intervention During Hemipelvectomy for Advanced Pelvic Malignancy: Experience From a Comprehensive Cancer
Jas Singh1, Valerae O Lewis2, Justin E Bird2
1Division of Urology, McGill University, Montreal, Quebec, Canada; Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Urological interventions were needed in 8.1% of hemipelvectomy cases for pelvic cancers. Most common procedures involved bladder, prostate, or urethral mobilization, with urinary retention and incontinence as key complications.
Area of Science:
- Urology
- Surgical Oncology
- Pelvic Reconstruction
Background:
- Hemipelvectomy is a complex procedure for locally advanced bony pelvic cancers.
- Urological structures are frequently at risk during pelvic resections.
- Understanding urological intervention rates is crucial for surgical planning and patient outcomes.
Purpose of the Study:
- To determine the incidence and types of urological interventions required during hemipelvectomy.
- To analyze urological complications following hemipelvectomy for pelvic cancers.
Main Methods:
- Retrospective review of 221 hemipelvectomy cases (internal and external) from 2011-2020.
- Data included tumor histology, resection type (Enneking/Dunham), and urological procedures.
- Complications were classified using the Clavien-Dindo system.
Main Results:
- 18 patients (8.1%) required intraoperative urological intervention.
- Interventions were most common in Type III resections (pubic involvement).
- Common procedures included bladder/prostate/urethral mobilization (31%), cystorrhaphy (22%), and cystectomy with urinary diversion (13%).
Conclusions:
- Urological intervention during hemipelvectomy is relatively uncommon but necessary in specific cases.
- Mobilization of the ureter, bladder, prostate, and urethra are key areas of intervention.
- Urinary retention and incontinence were the most frequent complications observed.
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