Retrospective review of pelvic malignancies undergoing total pelvic exenteration

Total pelvic exenteration is a highly morbid procedure performed for locally advanced pelvic malignancies. We describe our experience with three patients who underwent robotic total pelvic exenteration with laparoscopic rectus flap and compare perioperative characteristics to our open experience. Demographic, tumor, operative, and perioperative factors were examined with descriptive statistics reported. Mean operative times were similar between the two groups. When compared to open total pelvic exenteration cases(n=9), median estimated blood loss, ICU stay, and hospital stay were all decreased. These data show robotic pelvic exenteration with laparoscopic rectus flap is technically feasible. The surgery was well tolerated with low blood loss and comparable operative times to the open surgery. Further study is needed to confirm the oncologic efficacy and the suggested improvement in surgical morbidity.

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Staple‐transection of the dorsal venous complex and urethra in cooperative laparoscopic and transperineal endoscopic total pelvic exenteration for pelvic malignancies

Asian Journal of Endoscopic Surgery ◽

10.1111/ases.12932 ◽

2021 ◽

Author(s):

Toshiki Mukai ◽

Toshiya Nagasaki ◽

Takashi Akiyoshi ◽

Tomohiro Yamaguchi ◽

Yukiharu Hiyoshi ◽

...

Keyword(s):

Pelvic Exenteration ◽

Total Pelvic Exenteration ◽

Pelvic Malignancies

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Supralevator Total Pelvic Exenteration Without Colostomy — Case Report

Journal of Interdisciplinary Medicine ◽

10.1515/jim-2017-0060 ◽

2017 ◽

Vol 2 (3) ◽

pp. 258-261

Author(s):

Marian Botoncea ◽

Claudiu Molnar Varlam ◽

Adrian Chiujdea ◽

Călin Molnar

Keyword(s):

Case Report ◽

Pelvic Exenteration ◽

Percutaneous Nephrostomy ◽

Total Pelvic Exenteration ◽

Extensive Resection ◽

Reconstruction Process ◽

Recurrent Cervical Cancer ◽

Pelvic Malignancies ◽

Pelvic Cancer

Abstract Background: Pelvic exenteration is an ultra-radical surgical procedure described by Brunschwig in 1948, which attempts to surgically cure patients with recurrent pelvic cancer after radiotherapy. Several variants of pelvic exenteration are described that allow a more limited or extensive resection, depending on the stage of the disease. Case report: We report the case of a 54-year-old woman, who was diagnosed with a tumoral rectovaginal fistula after a recurrent cervical cancer that had been treated with a total hysterectomy with bilateral adnexectomy and a left percutaneous nephrostomy, as well as interaortocaval lymph node resection. The patient had undergone a supralevator total pelvic exenteration with pelvic and interaortocaval lymphadenectomy. The reconstruction process included right ureterostomy, left nephrostomy, and colocutaneous anal anastomosis (Parks procedure). Conclusions: Supralevator total pelvic exenteration provides hope for cure in patients with pelvic malignancies that reappear after radiotherapy. The restoration of the digestive tract and avoiding colostomy with a colocutaneous anastomosis increases the quality of life in these cases.

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708 PUBLICATION Total pelvic exenteration for pelvic malignancies

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(05)81003-1 ◽

2005 ◽

Vol 3 (2) ◽

pp. 201

Keyword(s):

Pelvic Exenteration ◽

Total Pelvic Exenteration ◽

Pelvic Malignancies

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A Single-Institution Approach to Total Pelvic Exenteration

The American Surgeon ◽

10.1177/000313481107701234 ◽

2011 ◽

Vol 77 (12) ◽

pp. 1629-1639

Author(s):

Ravi J. Chokshi ◽

Jeffrey Fowler ◽

David Cohn ◽

Robert Bahnson ◽

Joshua Lumbley ◽

...

Keyword(s):

Pelvic Exenteration ◽

Medical Center ◽

Surgical Oncology ◽

High Morbidity ◽

Complication Rates ◽

State University ◽

Total Pelvic Exenteration ◽

Pelvic Malignancies ◽

Severe Infections ◽

The Ohio State University

The objective of this study was to describe in detail the technique of total pelvic exenteration. Total pelvic exenteration (TPE) was first described in 1948 by Brunschwig. Since its description, complications of the procedure and surgical innovations have changed the approach to this radical surgery. We have described our institutional approach and outcomes of TPE. Fifty-four patients underwent TPE between 2004 and 2010 by the Division of Surgical Oncology at the Ohio State University Medical Center. Fifty-three patients have complete medical records available for review. Outcomes are described and have shaped these techniques. Patients were divided into various groups based on their histology: colorectal (n = 36), gynecologic (n = 6), urologic (n = 5), squamous cell (n = 2), sarcomatous disease (n = 3), and severe infections (n = 1). These were divided into two groups—colorectal (n = 36) and noncolorectal (n = 17)—for analysis. Demographics, operative time, length of stay, and complication rates were similar between the two groups. The median survival was 21.4 months for the colorectal group and 6.9 months for the noncolorectal group. Total pelvic exenteration for colorectal tumors has improved survival when compared with patients undergoing exenteration for pelvic malignancies of other origins. Total pelvic exenteration continues to be associated with high morbidity; however, with appropriate patient selection and proper operative technique, a perioperative mortality of 0 per cent can be achieved.

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