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Hemipelvectomy hernia: case series and literature review

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Abstract

Purpose

Hemipelvectomy is a major operation in which significant portions of the pelvic girdle and lower extremity are resected. The development of hernia following hemipelvectomy is a complex surgical challenge with limited published guidelines for management. We present our experience with three cases of hernia repair following internal hemipelvectomy and review the previously described ten cases of similar patients.

Methods

A systematic review of the current literature regarding hernias in the setting of hemipelvectomy was performed. A comprehensive search strategy on MEDLINE/PUBMED database searching for the key words of hemipelvectomy and hernia was used.

Results

There were 13 reported cases of incisional hernia after hemipelvectomy. The indication for hemipelvectomy was sarcoma in 77% of cases. The median time to presentation for hernia repair was 3 years following initial resection. Mesh repair was used in 77%. Identified risk factors for the development of incisional hernia included chemoradiation, wound infection, multiple operations, and weight gain. There was one event of hernia recurrence with a mean follow-up of 16 months.

Conclusion

Hernia in the setting of hemipelvectomy is an infrequently reported problem. General principles in management are similar to all hernia repairs and include local approximation of tissues, avoidance of contamination or wound infection, and use of prosthetic mesh when local tissue is inadequate for a tension-free repair.

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Authors and Affiliations

  1. Division of Bariatric and Gastrointestinal Surgery, Department of Surgery - Virginia Commonwealth University Health System, P.O. Box 980645, Richmond, VA, USA

    W. C. Hope, L. C. Ferro, L. D. Procter & J. L. Salluzzo

  2. Department of Surgery, Wellspan Good Samaritan Hospital, Lebanon, PA, USA

    J. A. Snyder

Authors
  1. W. C. Hope
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  2. L. C. Ferro
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  3. J. A. Snyder
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  4. L. D. Procter
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  5. J. L. Salluzzo
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Correspondence to J. L. Salluzzo.

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Hope, W.C., Ferro, L.C., Snyder, J.A. et al. Hemipelvectomy hernia: case series and literature review. Hernia 25, 1159–1167 (2021). https://doi.org/10.1007/s10029-020-02258-8

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  • DOI: https://doi.org/10.1007/s10029-020-02258-8

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