Background: Hemicorporectomy is a radical surgical procedure that is rarely performed. The procedure requires urinary and fecal diversion, disarticulation of the lumbar spine, and resection of the bony pelvis, the pelvic organs, and both lower extremities. In patients with locally advanced pelvic malignancies and intractable pressure wounds with underlying pelvic osteomyelitis, hemicorporectomy may be offered as a last resort.

Methods: The authors present a retrospective study of a single institution's 21-year experience with this technique. Eleven translumbar amputations were performed. Available clinical data were analyzed, including indications, perioperative complications and follow-up results. A literature review is presented and important perioperative and postoperative considerations are discussed.

Results: Of the 11 patients reviewed, there were no perioperative mortalities. The majority of the defects were not closed primarily; instead, total and subtotal thigh flaps were used for the reconstruction in most cases. Wound complications, pulmonary complications, and small bowel obstruction were the most frequent perioperative morbidities.

Conclusions: Hemicorporectomy is a viable option for management of locally advanced pelvic malignancies or intractable pressure wounds. A multi-disciplinary approach must be employed to limit mortality and morbidity. Good long term results can be obtained with proper patient selection, a well-designed operative plan, and attentive postoperative management.