HEMIPELVECTOMIES AT HOSPITAL DE CLÍNICAS DE UBERLÂNDIA: A SERIE OF CASES

1. Female, 18 years, diagnoses of giant cell tumor at left ileum, submitted to hemipelvectomy type I after neoadjuvant treatment. Evolved with metastatic implants in pelvis, submitted to rectosigmoidectomy, hysterectomy, right salpingioophorectomy and lymphadenectomy. 2. Male, 26 years, with eschar in bilateral ischial tuberosity and progression to chronic osteomyelitis. Submitted to hemipelvectomy type II with resection of right ischium. 3. Male, 27 years, with trauma history in pelvic region, showed in a radiography lesion in left hemipelvis. Biopsy evidenced chondrossarcoma grade II. Submitted to hemipelvetomy type I + II. 4. Female, 53 years, diagnoses of chondrossarcoma at left ilium, submitted to hemipelvectomy type I. 5. Male, 63 years, history of infected eschar and chronica osteomyelitis in sacrum. Submitted to hemipelvectomy type III and resection of right femoral head associated to osteosynthesis. 6. Male, 37 years, diagnoses of chronic osteomyelitis at left ischiopubic ramus and abductor muscle. Submitted to hemipelvectomy type III. 7. Female, 22 years, history of pain at the right hip associated with tumor at the level of inguinal region, Biopsy evidenced giant cell tumor, submitted to hemipelvectomy type III. Hemipelvectomy can be divided as internal or external. The internal hemipelvectomy is indicated in cases of minor tumors, limited to one hemipelvis, not compromising the lower limb or neurovascular structures. It can be divided in four types, as proposed by Enneking: type I (iliac resection), type II (periacetabular resection), type III (pubis resection) and type IV ( block resection of the hemipelvis). Furthermore, its commom the combination of types II + III. The postoperative of the patients submitted to internal hemipelvectomy requires thromboprophylaxis cares, early limb mobilization and load between 6090 days. Most common complications include surgical site infection, suture dehiscensce, fibulars graft release (when used to pelvic reconstruction), neuropraxy and thromboembolic events. Hemipelvectomies are large procedures, with important impact in patients life and require specialized and experienced surgical team, once surgical technic is complex and the risk of adverse events is high.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019