Translumbar amputation.
Six patients underwent translumbar amputation (TLA), a life-saving procedure, after standard modalities of therapy failed to control the progression of the disease. The primary diagnoses were as follows: pelvic arterial-venous (A-V) malformation, 1; sacral chordoma, 3; giant cell tumor of the sacrum, 1; and paraplegia with squamous cell cancer arising in intractable decubitus, 1. There were no operative deaths. The following postoperative complications developed in five patients: urinary fistulae, 2; small bowel obstruction, 1; intraabdominal bleeding, 1; hypertension, 2; small bowel fistula, 1; and dehiscence of skin closure, 1. Two patients died with distant metastases (24 months) and distant metastases with local recurrence (6 months). The remaining four patients were alive and well 72, 56, 48, and 18 months after the surgical procedure. All of these patients have reached the rehabilitation goals.
Terz
J J
JJ
Division of Surgery, City of Hope National Medical Center, California 91010.
Schaffner
M J
MJ
Goodkin
R
R
Beatty
J D
JD
Razor
B
B
Weliky
A
A
Shimabukuro
C
C
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation; D000768:Anesthesia, General; D001165:Arteriovenous Malformations / Q000601:surgery; D002817:Chordoma / Q000601:surgery; D005260:Female; D005870:Giant Cell Tumors / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010030:Ostomy; D010264:Paraplegia / Q000601:surgery; D010386:Pelvic Neoplasms / Q000601:surgery; D010388:Pelvis / Q000098:blood supply; D026741:Physical Therapy Modalities; D003668:Pressure Ulcer / Q000601:surgery; D019736:Prostheses and Implants; D013115:Spinal Canal / Q000601:surgery; D013125:Spinal Neoplasms / Q000601:surgery