Application of Hip Amputation Under Non-Ischemic Condition in the Treatment of Sarcomar

Background: Amputation is an effective treatment for sarcoma of the hip. Traditional amputation is performed by separating the major arteries and veins of the limb and blocking the blood supply to the limb, which may have adverse effects on the patient.Methods: Ten patients with pathologically clearly diagnosed bone and soft tissue sarcoma undergoing hip amputation in a non-ischemic state between April 2019 and April 2021 at the Affiliated Cancer Hospital of Harbin Medical University were selected. Factors related to operative time, intraoperative bleeding, phantom limb pain, incisional infection, and flap necrosis were statistically evaluated at 7 days postoperatively and 3 months postoperatively.Results: Ten patients were followed up for 3-24 months with a mean of 13 months. No bleeding secondary surgical complications occurred in all patients, and none had postoperative infections. Postoperative flap necrosis occurred in one case in the modified hemipelvic amputation patients, and no flap necrosis occurred in the hip disarticulation patients. In the non-ischemic hemipelvic amputation group, the operation time was 4.5-5.5h, with a mean of 5h, and the operation bleeding volume was 300-1000ml, with a mean of 700ml; in the hip disarticulation group, the operation time was 2.5-3.5h, with a mean of 2.9h, and the operation bleeding volume was 300-450ml, with a mean of 357ml; phantom limb pain in the non-ischemic amputation group 7 days after operation, the VAS pain score was 4 -6 points, mean 4.5 points; VAS pain score 3-4 points, mean 3.4 points at 3 months postoperatively.Conclusions: In hip amputation for bone and soft tissue sarcoma, the main arterial and venous approaches to the limb are ligated near the end of surgery, leaving the amputated limb in a non-ischemic state at the distal end of the amputation, without pathological reactions due to limb ischemia. Non-ischemic hip amputation is more suitable for the surgical treatment of locally advanced lesions of sarcoma.Trial registration: retrospectively registered