Hemicorporectomy

The Hemikorporektomie referred to in medicine a complete amputation of both legs, pelvis and the removal of the lower abdomen.

Indication

This operation is one of the heaviest and most consequential interventions in surgery and is applied as a maximum intervention only in rare cases. In the medical literature, less than 50 of such operations are previously documented worldwide. Indicated the Hemikorporektomie is for extended, non-metastatic carcinoma in the pelvic region, with intractable Decubitusgeschwüren with malignancies, in osteomyelitis associated with paraplegia and in extensive pelvic trauma.

Operation

During the operation of the pelvic bone, the legs, the external genitals, the bladder, the rectum and the anus is removed. The vital organs remain in the upper body cavity. Since the procedure will involve an interruption of the efferent urinary tract and the rectum, the patient an artificial outlet for urine ( urostomy ) and chair ( enterostomy ) must be specified.

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

Complications

The removal of a large part of the body and thus the blood vessels can lead to significant problems of blood circulation. A relatively small reduction in blood volume can quickly lead to a peripheral circulatory collapse, an increase in blood volume bears the risk of the formation of pulmonary edema. The reduction of abdominal wall function can lead to a reduction of the vital capacity of the lungs.

Forecast

The operation has survival rates of 30 % in cancer patients and 70 % of trauma -related Hemikorporektomie. Through an intensive pre-and post-operative counseling and an extended rehabilitation, quality of life can be increased significantly after surgery compared to the time of diagnosis.