Vol 73, No 2 (2023)
Review paper
Published online: 2023-04-14

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External hemipelvectomy. A last resort operation

Leszek Kołodziejski12, Józef Duber1, Piotr Pomykacz1, Andrzej L. Komorowski34
Nowotwory. Journal of Oncology 2023;73(2):81-84.


An external hemipelvectomy (hindquarter amputation) is a major mutilating amputation that includes the lower extremity and half of the pelvic rim. It is rarely performed due to its mutilating character and the technical difficulties involved. The main indications for the operation include sarcomas and extensive trauma. In this paper, the authors discuss the historical aspects and current status of this rare operation, as well as its role in the oncological approach to sarcomas.

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  1. Ham SJ, Kroon HM, Koops HS, et al. Osteosarcoma of the pelvis-oncological results of 40 patients registered by The Netherland Committee of Bone Tumors. Eur J Surg Oncol. 2000; 26(1): 53–60.
  2. Prewitt TW, Alexander HR, Sindelar WF. Hemipelvectomy for soft tissue sarcoma: clinical results in fifty-three patients. Surg Oncol. 1995; 4(5): 261–269.
  3. Wirbel RJ, Schulte M, Mutschler WE. Surgical treatment of pelvic sarcomas: oncologic and functional outcome. Clin Orthop Relat Res. 2001(390): 190–205.
  4. Lewis V, Kemp A, Roubaud M, et al. Multidisciplinary Approach to Hemipelvectomy for Pelvic Sarcomas. JBJS Reviews. 2022; 10(5).
  5. Han I, Lee YM, Cho HS, et al. Outcome after surgical treatment of pelvic sarcomas. Clin Orthop Surg. 2010; 2(3): 160–166.
  6. Senchenkov A, Moran SL, Petty PM, et al. Predictors od Complication and Outcomes of External Hemipelvectomy Wounds: Account of 160 Consecutive Ceses. Ann Surg Oncol. 2008; 15(1): 355–363.
  7. Higinbotham NL, Marcove RC, Casson P. Hemipelvectomy: a clinical study of 100 cases with 5-year-followup on 60 patients. Surgery. 1996; 59(5): 706–708.
  8. Wedemeyer C, Kauther MD. Hemipelvectomy- only a salvage therapy? Orthop Rev (Pavia). 2011; 3(1): e4.
  9. Apffelstaedt JP, Driscoll DL, Spellman JE, et al. Complications and outcome of external hemipelvectomy in the management of pelvic tumors. Ann Surg Oncol. 1996; 3(3): 304–309.
  10. Pringle JH. Some notes on the interpelvi-abdominal amputation, with a report of three cases. Lancet. 1909; 173: 530–533.
  11. Mat Saad AZ, Halim AS, Faisham WI, et al. Soft tissue reconstruction following hemipelvectomy: eight-year experience and literature review. ScientificWorldJournal. 2012; 2012: 702904.
  12. Patch DA, Hess MC, Spitler CA, et al. Diagnosis and Management of Traumatic Hemipelvectomy. J Am Acad Orthop Surg. 2022; 30(18): 888–895.
  13. He Yu, Qiu D, Zhou D, et al. Treatment of Partial Traumatic Hemipelvectomy: A Study of 21 Cases. J Bone Joint Surg Am. 2019; 101(9): e36.
  14. Fromm J, Klein A, Baur-Melnyk A, et al. Survival and prognostic factors in conventional central chondrosarcoma. BMC Cancer. 2018; 18(1): 849.
  15. Pieńkowski A, Komor A, Goryń T, et al. The outcomes of limb--sparing surgery of patients with chondrosarcoma of the pelvis. Nowotwory J Oncol. 2021; 71(6): 336–342.
  16. COLEY BL, HIGINBOTHAM NL, ROMIEU C. Hemipelvectomy for tumors of bone; report of fourteen cases. Am J Surg. 1951; 82(1): 27–43.
  17. Banskota N, Yang H, Fang X, et al. Comparative study of pelvic sarcoma patients undergoing internal and external hemipelvectomy: A meta-analysis study. Front Surg. 2022; 9: 988331.
  18. Spałek MJ, Poleszczuk J, Czarnecka AM, et al. Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis. Cells. 2021; 10(2).
  19. Mayerson JL, Wooldridge AN, Scharschmidt TJ. Pelvic resection: current concepts. J Am Acad Orthop Surg. 2014; 22(4): 214–222.
  20. Machak GN, Tkachev SI, Solovyev YN, et al. Neoadjuvant chemotherapy and local radiotherapy for high-grade osteosarcoma of the extremities. Mayo Clin Proc. 2003; 78(2): 147–155.
  21. Baliski CR, Schachar NS, McKinnon JG, et al. Hemipelvectomy: a changing perspective for a rare procedure. Can J Surg. 2004; 47(2): 99–103.
  22. Miller TR. 100 cases of hemipelvectomy: a personal experience. Surg Clin North Am. 1974; 54(4): 905–913.
  23. Bohm P. Hemipelvectomy: report of 12 cases, review of the literature and therapeutic implications. J Orthop Sci. 1997; 2: 414–423.
  24. Sayeed MdS, Oakman J, Dillon MP, et al. Influential factors for access to and participation in rehabilitation for people with lower limb amputation in East, South, and Southeast Asian developing countries: a scoping review. Disabil Rehabil. 2022; 44(25): 8094–8109.
  25. Gavrankapetanovic I, Gavrankapetanovic F, Becirbegovic S, et al. [Hemipelvectomy, constant surgical dilema]. Rozhl Chir. 2007; 86(12): 661–665.
  26. Vander Griend RA. Osteosarcoma of the pelvis. A clinical and histopathological study of 25 patients. J Bone Joint Surg Am. 1992; 74: 321–330.

Nowotwory. Journal of Oncology