Hemicorporectomy

In medicine, the hemicorporectomy describes a complete amputation of both legs, the pelvis and the removal of the abdomen.

indication

This operation is one of the most difficult and serious interventions in surgery and is only used as a maximum intervention in rare cases. Fewer than 50 such operations have been documented in the medical literature to date. Hemicorporectomy is indicated for extensive, non- metastatic carcinomas in the pelvic area , for non- treatable decubitus ulcers with malignant degeneration, for osteomyelitis in connection with paraplegia and for extensive pelvic trauma .

surgery

The operation removes the pelvic bones, legs, external genitals , bladder , rectum, and anus . The vital organs remain in the upper body cavity. Since the procedure involves an interruption of the urinary organs and the rectum, the patient must be provided with an artificial outlet for urine ( urostomy ) and stool ( enterostomy ).

The procedure was proposed in 1951 and first performed on a patient in 1960.

Complications

Removing a large part of the body, and with it the blood vessels, can cause significant blood circulation problems. Even a relatively small reduction in blood volume can quickly lead to a peripheral circulatory collapse; an increase in blood volume carries the risk of developing pulmonary edema . The lowering of the abdominal wall function can lead to a reduction in the vital capacity of the lungs.

forecast

The operation has survival rates between 30% for cancer patients and 70% for trauma-induced hemicorporectomy. Intensive pre- and post-operative advice and extensive rehabilitation can significantly improve the quality of life after the operation compared to the time of diagnosis.

See also

• Hemipelvectomy
• Exenteration

Individual evidence

1. ↑ Hemicorporectomy from Gesundheit.de, accessed on May 15, 2016.
2. ↑ Kennedy DS, Miller EB, McLean DC, Perlis MS, Dion RM, Horvitz VS., Lumbar amputation or hemicorporectomy for advanced malignancy of the lower half of the body , In: Surgery 48: 357-365, 1960 PMID 13848487
3. ↑ Hemicorporectomy for scar cancer in decubitus ulcers as an interdisciplinary maximum intervention. at egms.de, accessed on May 15, 2016.

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