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Updated: Aug 14, 2026
Right Hemihepatectomy by Suprahilar Intrahepatic Transection of the Right Hemipedicle using a Vascular Stapler
Published on: January 25, 2010
Partial and complete internal hemipelvectomy: complications and long-term follow-up
J P Apffelstaedt1, D L Driscoll, C P Karakousis
1Soft Tissue, Melanoma and Bone Service, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Background:
The complications and long-term follow-up results of internal hemipelvectomy are not well documented.
Study Design:
We reviewed 32 internal hemipelvectomies performed between 1976 and 1994.
Results:
The pathologic diagnoses were soft tissue sarcoma in 15 cases, bone tumor in 14 cases, melanoma in two cases, and carcinoma in one of the cases. In 24 cases, the intent of surgery was curative; in 22 cases, the procedure was modified. Average blood loss was 3.2 L; the procedure took on average 7.5 hours. Complications included skin flap necrosis in four cases, infection in 15 cases, and various other complications in five cases. Three mortalities (9 percent) occurred. Thirty-four percent of the patients ambulated without any assistance, 59 percent ambulated with crutches, while 7 percent remained wheel-chair bound. The survival rate after resection for cure was 45 percent at ten years compared with 29 percent at two years for palliative resections.
Conclusions:
Internal hemipelvectomy is a complex procedure that is functionally and cosmetically superior to external hemipelvectomy and, when done with curative intent, results in considerable long-term survival rates.
Insights
Internal hemipelvectomy is a complex surgery for pelvic tumors. While complications occur, it offers better function and survival rates than external hemipelvectomy, especially with curative intent.
Area of Science:
- Surgical Oncology
- Orthopedic Surgery
- Pelvic Reconstruction
Background:
- Complications and long-term outcomes of internal hemipelvectomy are not well-documented.
- Internal hemipelvectomy is a complex surgical procedure.
Purpose of the Study:
- To document the complications and long-term follow-up results of internal hemipelvectomy.
- To evaluate functional outcomes and survival rates associated with internal hemipelvectomy.
Main Methods:
- Retrospective review of 32 internal hemipelvectomy cases performed between 1976 and 1994.
- Analysis of pathological diagnoses, surgical approach, complications, functional status, and survival rates.
Main Results:
- Common diagnoses included soft tissue sarcoma (15) and bone tumors (14).
- Average blood loss was 3.2 L, and operative time averaged 7.5 hours.
- Complications included infection (15 cases) and skin flap necrosis (4 cases). Functional outcomes showed 34% ambulated independently, 59% with crutches, and 7% wheelchair-bound.
- Ten-year survival rates were 45% for curative resections versus 29% at two years for palliative resections.
Conclusions:
- Internal hemipelvectomy is a complex procedure with significant morbidity but offers functional and cosmetic advantages over external hemipelvectomy.
- Curative intent internal hemipelvectomy is associated with considerable long-term survival rates.
