PARTIAL AND COMPLETE INTERNAL HEMIPELVECTOMY - COMPLICATIONS AND LONG-TERM FOLLOW-UP

BACKGROUND: The complications and long-term follow-up results of inter nal 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 t umor in 14 cases, melanoma in two cases, and carcinoma in one of the c ases. In 24 cases, the intent of surgery was curative; in 22 cases, th e procedure was modified. Average blood loss was 3.2 L; the procedure took on average 7.5 hours. Complications included skin flap necrosis i n four cases, infection in 15 cases, and various other complications i n five cases. Three mortalities (9 percent) occurred. Thirty-four perc ent of the patients ambulated without any assistance, 59 percent ambul ated with crutches, while 7 percent remained wheelchair bound. The sur vival rate after resection for cure was 45 percent at ten years compar ed 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 wi th curative intent, results in considerable long-term survival rates.