Last-resort lower-body amputation effective in extreme cases of bone infection, 25-year review shows

Nov 17, 2009

A landmark, 25-year review of cases in which surgeons had to remove the lower portion of the body from the waist down for severe pelvic bone infections shows the therapy can add years and quality of life to survivors, say researchers at UT Southwestern Medical Center.

The rarely performed is called a hemicorporectomy or translumbar amputation, and involves removing the entire body below the waist, including legs, pelvic bone and urinary system.

"It is used as a last resort on patients with potentially fatal illnesses such as certain cancers or complications from ulcers in the pelvic region that cannot otherwise be contained," said Dr. Jeffrey Janis, associate professor of plastic surgery at UT Southwestern and lead author of the study, which appears in the October issue of Plastic and . "We determined that it can be effective and a reasonable consideration in some of these extreme cases."

Hemicorporectomy rarely has been performed because of the very limited indications for the procedure, said senior author Dr. Robert McClelland, professor emeritus of surgery at UT Southwestern.

"An increasing number of veterans of Iraq and Afghanistan conflicts are surviving very severe injuries that frequently lead to permanent paraplegia and are often complicated by severe bedsores and intractable bone infection, which is potential a source of fatal sepsis. Because of this, the frequency of indications for hemicorporectomy may soon increase significantly," Dr. McClelland said.

Only 57 cases of translumbar amputations had been recorded in medical literature worldwide, although the researchers suspect more have occurred since the initial referencing in 1960. The authors added to their review nine UT Southwestern patients who had received the procedure as a result of terminal pelvic osteomyelitis, a type of bone infection.

About a third of the 66 patients survived at least nine years after having a hemicorporectomy. Of those who had the procedure for the bone infection, more than half survived at least nine years. Of the nine terminal pelvic osteomyelitis-driven patients treated at UT Southwestern, four remained alive after 25 years and the average survival was 11 years.

"Though it is impossible to know how the survival rate would compare had these patients not undergone the amputation, given the severe disease involved, it is reasonable to assume they survived longer than they would have without surgery. Most importantly, our survivors reported that they were satisfied with their decision to have the procedure," said Dr. Janis, who is also chief of and wound care for Parkland Health & Hospital System, the primary teaching institution of UT Southwestern.

Source: UT Southwestern Medical Center (news : web)

Explore further: What to do with kidneys from older deceased donors?

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.