Soft Tissue Reconstruction following Hemipelvectomy: Eight-Year Experience and Literature Review

Table 1

Patient summary.

No.	Age/ sex	Diagnosis	Stage	Resection type^t	Reconstruction	Complication	Chemotherapy/ radiotherapy	Outcome
1	49/M	Osteosarcoma	Stage IIB	P I-A, II, III	Musculocutaneous anteromedial fillet thigh flap	Small wound dehiscence	No	Alive 13 months post op, no local recurrent, crutches
2	25/M	Neurofibrosarcoma	Stage IIB	P I-S, II, III	Musculocutaneous fillet thigh flap SFA pedicle	Small wound dehiscence, dura tear intra-op	No	Died 2 months post op, bedbound.
3	19/M	Peripheral primitive neuroectodermal sarcoma	Stage III	P I-A, II, III	Anteromedial fasciocutaneous	No	Radiotherapy	Died 18 months post op, local recurrent and metastasis walking with crutches and riding motorbike, enjoy his life
4	54/F	Metastatic adenocarcinoma unknown primary	Stage III	P II, III	Random pattern	Wound infection, phantom limb	No	Died 2 months post op at home, bedbound, low self esteem
5	78/M	Malignant fibrous histiosarcoma	Stage III	P I-A, II, III	Random pattern	Septicaemia, wound infection	No	Uncontactable
6	69/F	Liposarcoma	Stage IIB	P II, III	Random pattern	Bladder dysfunction	Radiotherapy	Alive 14 months post op, no recurrent. walking frame
7	54/F	Metastatic SCC	Stage III	P I, II, III	Posterior thigh—gluteal myocutaneous flap—internal iliac vessel ligated	Died, partial flap necrosis	No	Died 6 days post op
8	24/F	Osteosarcoma (recurrent)	Stage IIB	P I, II, III	Fasciocutaneous skin perforators based on Lat circumflex femoral	Flap congestion 2ndary to femoral artery injury/ haematoma, re-explore x2 revascularisation of flap prox. to injured area	Yes	Alive 17 months post op, no recurrent, crutches
9	31/F	Synovial sarcoma	Stage III	L hemipelvectomy P-Is, PIIa, PIII	Musculocutaneous fillet thigh flap with vein anastomosis	Pain, phantom limb	Radiotherapy	Alive 14 months post op, wheelchair
10	17/M	Osteosarcoma	Stage IIB	P I, II, III	Musculocutaneous posterior flap hemipelvectomy	No	Yes	Alive 12 months post op, wheelchair
11	48/M	Chondrosarcoma (recurrent)	Stage IIB	P-I, II, III, plus pelvic exenteration, perineal resection, ileal conduit, colostomy	Musculocutaneous anterior fillet thigh flap	Flap congestion (compressed by bowel), wound dehiscence/Infection, haematoma from bleeder of int. iliac vessel, central line sepsis, enterocutaneous fistula, and delayed partial flap necrosis after multiple exploration of wound/surgical sites	No	Died 3 months post op, bedbound
12	13/M	Osteosarcoma	Stage III	P I, II, III	Gluteus maximus myocutaneous free flap	Flap congestion secondary to haematoma	Chemotherapy	Alive 10 months post op, crutches
13	18/M	Osteosarcoma	Stage III	P I, II, III	Posterior thigh—gluteal myocutaneous flap	No	Chemotherapy	Alive 6 months post op, crutches

^t According, Enneking and Dunham classification. See text for full description.