ArticleBMC musculoskeletal disorders2025
Separated-incision versus T-incision for internal hemipelvectomy related to Enneking type II + III resection: comparative outcomes in a single-center retrospective cohort.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe T-incision approach for internal hemipelvectomy necessitates extensive dissection to expose the posterior pelvic structures, leading to higher rates of wound complications. A modified separated-incision approach was developed and validated in this comparative study. PATIENTS AND
methodsThe separated-incision approach used two distinct incisions: an anterior incision that combines the ilioinguinal approach with a short, straight Smith-Petersen incision; and a separated posterior incision for the posterior pelvic structures. This approach was applied to 8 patients with internal hemipelvectomy related to type II + III regions. Seventeen patients underwent a traditional T-incision approach during the same period were matched for comparison.
resultsThe separated-incision approach was successfully performed in these eight patients, preserving the gluteal vessels and posterior skin-muscle flap. Lower blood loss (2375 vs. 3952 mL, p = 0.005), and similar operative time (312 vs. 398 min, p = 0.098) was observed. Postoperative haemoglobin was higher (88.1 vs. 74.8 g/L, p = 0.009), and drainage volumes were marginally reduced (1379 vs. 1917 mL, p = 0.209). Compared to 8 patients in the T-incision group who experienced wound complications including delayed wound healing (n = 4) and surgical site infection (n = 4), all patients in separated-incision group achieved primary wound healing within 3 weeks (47% vs. 0%, p = 0.026). Additionally, they had a shorter time to ambulation (39 vs. 62 days, p = 0.015) and higher MSTS scores (24.25 vs. 20.47, p = 0.006). No differences were observed in local recurrence or overall survival.
conclusionsThe separated-incision demonstrated fewer wound complications and faster mobilization, suggesting it is a promising alternative; multicentre validation is warranted. LEVEL OF EVIDENCE: Level III, Retrospective cohort study.
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