title: Hemicorporectomy: back to front.
abstract: 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, as well as creation of conduits for diversion of the urinary and fecal streams. A review of the literature reveals that the surgical technique has been relatively unchanged since 1960. The standard anterior to posterior approach is associated with significant blood loss and morbidity, likely contributing to lengthy hospital stay. Herein, we describe our back-to-front approach to hemicorporectomy, involving early division of the vertebral structures and spinal cord, pre-empting engorgement of Batson's plexus, thus minimizing blood loss. In addition, this approach greatly improves exposure of the pelvic vessels, allowing for a technically less challenging and safer procedure.
authors.affiliation: Department of Surgery, Denver Health Medical Center, University of Colorado, 777 Bannock St., Denver, CO 80204, USA. Carlton.Barnett@dhha.org
authors.forename: Carlton C
authors.initials: CC
authors.lastname: Barnett
authors.forename: Jamil
authors.initials: J
authors.lastname: Ahmad
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Janis
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Lemmon
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Morrill
authors.forename: Robert N
authors.initials: RN
authors.lastname: McClelland
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006428:Hemipelvectomy / Q000379:methods*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000150:complications / Q000601:surgery*; D003668:Pressure Ulcer / Q000601:surgery*; D013524:Surgical Flaps