Posterior pelvic exenteration and retrograde total hysterectomy in patients with locally advanced ovarian cancer: Clinical and functional outcome

Laura Doherty, FNP-BC, AOCNP®, of Women & Infants Hospital of Rhode Island/Brown University, interprets data on adjuvant chemotherapy for locally advanced cervical cancer, bevacizumab for advanced ovarian cancer, a new treatment option for platinum-resistant ovarian cancer patients, and side effects that long-term ovarian cancer survivors experience. Reporting by The ASCO Post.

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Modified posterior pelvic exenteration and rectosigmoid anastomosis for advance epithelial ovarian cancer: A safe cytoreductive procedure

10.1055/s-0039-1685294 ◽

2016 ◽

Author(s):

Rashmi Rekha Bora

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Pelvic Exenteration ◽

Residual Disease ◽

Circular Stapler ◽

Advanced Ovarian Cancer ◽

Length Of Hospital Stay ◽

Serous Carcinoma ◽

Retroperitoneal Lymph Node Dissection ◽

Bowel Movements

Introduction: Surgery plays an important role in the management of advanced stage ovarian cancer and is complex involving surgical procedures including peritonectomy, splenectomy, diaphragmatic stripping, retroperitoneal lymph node dissection and bowel resection including resection of recto-sigmoid. Objective: To assess the safety and efficacy of the patients undergoing modified posterior pelvic exenteration and rectosigmoid anastomosis achieving in optimal cytoreduction. Methods: Between June 2011 and June 2014 a total of 100 patients underwent surgical cytoreduction for advanced epithelial ovarian cancer of which 20 patients had undergone modified posterior pelvic exenteration with rectosigmoid anastomosis. The present study includes a retrospective analysis of these 20 patients. Rectosigmoid anastomosis was done using circular stapler in these patients. All patients had a PS score of 1 or 2. Results: The median age of patients was 50 years. The optimal status of no macroscopic residual disease was achieved in all patients. Modified posterior pelvic exenteration with rectosigmoid anastomosis was carried out to achieve optimal status of surgical cytoreduction in 20 patients out of which fifteen patients had primary surgical cytoreduction, three patients had interval surgical cytoreduction surgery after receiving three cycles of neoadjuvant chemotherapy with paclitaxel & carboplatin while two patients had this procedure as a part of secondary surgical cytoreduction. The most common histology was papillary serous carcinoma. Average blood loss was 500 ml. Mean operative time was 6 hours. There were no intra operative complications. Bowel movements returned to normal in 3 to 5 days. The median length of hospital stay was 7 days. The median time to start postoperative chemotherapy was 32 days. There was no major morbidity and mortality. Conclusion: Modified posterior pelvic exenteration with rectosigmoid anastomosis should be performed when indicated as a part of cytoreduction. In our experience this is a safe and effective procedure to achieve optimal status in advanced ovarian cancer.

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Comparison of Morbidity and Survival Between Primary and Interval Cytoreductive Surgery in Patients After Modified Posterior Pelvic Exenteration for Advanced Ovarian Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e318265d358 ◽

2012 ◽

Vol 22 (8) ◽

pp. 1349-1354 ◽

Cited By ~ 8

Author(s):

Aurélie Revaux ◽

Roman Rouzier ◽

Marcos Ballester ◽

Frédéric Selle ◽

Emile Daraï ◽

...

Keyword(s):

Ovarian Cancer ◽

Postoperative Complications ◽

Cytoreductive Surgery ◽

Pelvic Exenteration ◽

Advanced Ovarian Cancer ◽

Progression Free Survival ◽

Free Survival ◽

Global Rate ◽

Significant Difference ◽

Extensive Surgery

ObjectiveSurgical management of advanced ovarian cancer often requires low modified posterior pelvic exenteration (MPE) to achieved complete resection. The aim of this study was to evaluate the morbidity of MPE at the time of primary cytoreductive surgery (PCS) and interval cytoreductive surgery (ICS) after neoadjuvant chemotherapy.Materials and MethodsFrom 2001 to 2009, 63 patients underwent MPE for advanced ovarian cancer. We analyzed and compared surgical characteristics and postoperative courses between PCS and ICS.ResultsModified posterior pelvic exenteration was performed during PCS for 50 patients (79%) and during ICS for 13 patients (21%). Complete cytoreduction was achieved in 80% of patients (84% in the PCS group and 69% in the ICS group; ns). There was no significant difference between the PCS and ICS groups in the type and the rate of standards or radical surgical procedures. Patients with ICS had a shorter length of stay in the intensive care unit (0.9 vs 2.7 days; P = 0.009), but there was no difference in the total length of hospitalization (P = 0.94). The global rate of postoperative complications was 76%. No differences were found between the 2 groups in digestive or extradigestive complications, iterative surgery, or interventional radiology procedures. The median overall survival was 49.4 months in the PCS group and 27.1 months in the ICS group (P = 0.27), and the median progression-free survival time in both groups was 20 months.ConclusionsThere was no difference in the occurrence of postoperative complications between PCS and ICS, especially in morbidity related to MPE. The specific morbidity of this surgical procedure remained low compared with the overall morbidity in cases of extensive surgery.

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Feasibility and rationale of a novel approach in advanced ovarian cancer surgery: Bat- shaped en-bloc total peritonectomy and total hysterectomy salpingo-oophorectomy with or without rectosigmoid resection (Sarta-Bat approach)

Gynecologic Oncology ◽

10.1016/j.ygyno.2020.11.011 ◽

2020 ◽

Author(s):

Ghanim Khatib ◽

Sevtap Seyfettinoglu ◽

Ahmet Baris Guzel ◽

Umran Kucukgoz Gulec ◽

Hakkı Unlugenc ◽

...

Keyword(s):

Ovarian Cancer ◽

Advanced Ovarian Cancer ◽

Cancer Surgery ◽

En Bloc ◽

Rectosigmoid Resection ◽

Total Hysterectomy ◽

Novel Approach

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An alternative approach to treatment of inferior vena cava filter perforation

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.180131 ◽

2020 ◽

Vol 19 ◽

Author(s):

Mariana Krutman ◽

Guilherme Yazbek ◽

Kenji Nishinari ◽

Bruno Soriano Pignataro ◽

Guilherme Andre Zottele Bomfim ◽

...

Keyword(s):

Ovarian Cancer ◽

Inferior Vena Cava ◽

Inferior Vena Cava Filter ◽

Inferior Vena ◽

Locally Advanced ◽

Vena Cava ◽

Advanced Ovarian Cancer ◽

Vena Cava Filter ◽

Less Invasive ◽

Alternative Approach

Abstract We report a case of inferior vena cava filter perforation immediately after filter implantation, recognized intraoperatively in a patient undergoing laparotomy for resection of locally advanced ovarian cancer. We describe an alternative approach with strut resection, less invasive than filter removal, enabling the device to be maintained and bleeding to be controlled.

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