A 25-year experience with hemicorporectomy for terminal pelvic osteomyelitis

Jeffrey E. Janis, Jamil Ahmad, Joshua A. Lemmon, Carlton C. Barnett, Kevin C. Morrill, Robert N. McClelland

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND:: Hemicorporectomy involves amputation of the pelvis and lower extremities by disarticulation through the lumbar spine with concomitant transection of the aorta, inferior vena cava, and spinal cord. In addition, conduits are constructed for diversion of both the urinary and fecal streams. Of 57 cases reported in the literature, limited experience exists with hemicorporectomy for terminal pelvic osteomyelitis, with only 11 cases described. Furthermore, there is little information available regarding perioperative mortality and long-term survival. This article describes the largest reported series of hemicorporectomies performed for terminal pelvic osteomyelitis. METHODS:: A retrospective review of the medical records for nine patients who underwent hemicorporectomy at the authors' institution was conducted followed by interviews with all surviving patients. RESULTS:: At follow-up, four patients were alive and five patients were dead. For all patients, the average survival after hemicorporectomy was 11.0 years (range, 1.7 to 22.0 years). There was no perioperative mortality within 30 days of surgery. None of the surviving patients suffered from recurrent decubitus ulcers. CONCLUSIONS:: Including this clinical series, a total of 66 hemicorporectomies have now been reported in the literature. Twenty cases were performed for terminal pelvic osteomyelitis with no mortality within 30 days of surgery, and 53.3 percent of patients were alive and well at long-term follow-up. Given the low perioperative mortality along with the ability of patients to achieve long-term survival following this operation, hemicorporectomy should be offered to appropriate patients suffering from terminal pelvic osteomyelitis.

Original languageEnglish (US)
Pages (from-to)1165-1176
Number of pages12
JournalPlastic and Reconstructive Surgery
Volume124
Issue number4
DOIs
StatePublished - Oct 2009

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Osteomyelitis
Mortality
Ambulatory Surgical Procedures
Survival
Disarticulation
Urinary Diversion
Pressure Ulcer
Inferior Vena Cava
Pelvis
Amputation
Medical Records
Aorta
Lower Extremity
Spinal Cord
Spine
Interviews

ASJC Scopus subject areas

  • Surgery

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A 25-year experience with hemicorporectomy for terminal pelvic osteomyelitis. / Janis, Jeffrey E.; Ahmad, Jamil; Lemmon, Joshua A.; Barnett, Carlton C.; Morrill, Kevin C.; McClelland, Robert N.

In: Plastic and Reconstructive Surgery, Vol. 124, No. 4, 10.2009, p. 1165-1176.

Research output: Contribution to journalArticle

Janis, Jeffrey E. ; Ahmad, Jamil ; Lemmon, Joshua A. ; Barnett, Carlton C. ; Morrill, Kevin C. ; McClelland, Robert N. / A 25-year experience with hemicorporectomy for terminal pelvic osteomyelitis. In: Plastic and Reconstructive Surgery. 2009 ; Vol. 124, No. 4. pp. 1165-1176.
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AB - BACKGROUND:: Hemicorporectomy involves amputation of the pelvis and lower extremities by disarticulation through the lumbar spine with concomitant transection of the aorta, inferior vena cava, and spinal cord. In addition, conduits are constructed for diversion of both the urinary and fecal streams. Of 57 cases reported in the literature, limited experience exists with hemicorporectomy for terminal pelvic osteomyelitis, with only 11 cases described. Furthermore, there is little information available regarding perioperative mortality and long-term survival. This article describes the largest reported series of hemicorporectomies performed for terminal pelvic osteomyelitis. METHODS:: A retrospective review of the medical records for nine patients who underwent hemicorporectomy at the authors' institution was conducted followed by interviews with all surviving patients. RESULTS:: At follow-up, four patients were alive and five patients were dead. For all patients, the average survival after hemicorporectomy was 11.0 years (range, 1.7 to 22.0 years). There was no perioperative mortality within 30 days of surgery. None of the surviving patients suffered from recurrent decubitus ulcers. CONCLUSIONS:: Including this clinical series, a total of 66 hemicorporectomies have now been reported in the literature. Twenty cases were performed for terminal pelvic osteomyelitis with no mortality within 30 days of surgery, and 53.3 percent of patients were alive and well at long-term follow-up. Given the low perioperative mortality along with the ability of patients to achieve long-term survival following this operation, hemicorporectomy should be offered to appropriate patients suffering from terminal pelvic osteomyelitis.

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