To the Editor.—We read with interest the article by Douglass and associates entitled "Hemipelvectomy" (Arch Surg 110:82, 1975). We were struck with the emphasis on major blood loss in an amount, on the average, that more than doubles that to which we are accustomed, using specific techniques that we have employed for more than ten years, but that are not mentioned in this article.
Except when the tumor involves an area no higher than the upper part of the thigh, and has little metastasizing potential, we employ the following technique:
The entire abdomen is prepared and draped at the same time as the usual preparation and draping for hemipelvectomy. Abdominal exploration is carried out through a midline incision. This permits early determination of the upper extent of neoplastic involvement, the presence or absence of node metastases in the para-aortic and iliac chains, and the presence or absence of liver